Provider Demographics
NPI:1972757649
Name:FERGUSON, KERRY HASTINGS (ND)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:HASTINGS
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-1342 KAIMINANI DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8536
Mailing Address - Country:US
Mailing Address - Phone:480-495-0381
Mailing Address - Fax:
Practice Address - Street 1:73-5681 MAIAU ST.
Practice Address - Street 2:SUITE 204 A
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:480-495-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND-182175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath