Provider Demographics
NPI:1013574318
Name:FERGUSON, TAMIYA JUNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAMIYA
Middle Name:JUNE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1477
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NV
Mailing Address - Zip Code:89415-1477
Mailing Address - Country:US
Mailing Address - Phone:775-945-3657
Mailing Address - Fax:
Practice Address - Street 1:331 1ST STREET
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NV
Practice Address - Zip Code:89415
Practice Address - Country:US
Practice Address - Phone:775-945-3657
Practice Address - Fax:775-945-2039
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN72406163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health