Provider Demographics
NPI:1023196441
Name:FERGUSON, MARIANNE M (RNMSNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:M
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RNMSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:764 WEST GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152
Mailing Address - Country:US
Mailing Address - Phone:315-685-1691
Mailing Address - Fax:315-685-1695
Practice Address - Street 1:764 WEST GENESEE ST
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152
Practice Address - Country:US
Practice Address - Phone:315-685-1691
Practice Address - Fax:315-685-1695
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF4200441363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology