Provider Demographics
NPI:1003660770
Name:FERGUSON, HAYLEE MACKENZIE (ATS)
Entity Type:Individual
Prefix:
First Name:HAYLEE
Middle Name:MACKENZIE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 YORK CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1338
Mailing Address - Country:US
Mailing Address - Phone:615-571-5437
Mailing Address - Fax:
Practice Address - Street 1:1015 DANA AVE APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2224
Practice Address - Country:US
Practice Address - Phone:615-571-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer