Provider Demographics
NPI:1053327809
Name:FERGUSON, URSULA INGE
Entity Type:Individual
Prefix:DR
First Name:URSULA
Middle Name:INGE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 BLAZING CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4023
Mailing Address - Country:US
Mailing Address - Phone:702-492-0419
Mailing Address - Fax:702-636-3041
Practice Address - Street 1:901 RANCHO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3836
Practice Address - Country:US
Practice Address - Phone:702-636-3040
Practice Address - Fax:702-636-3041
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine