Provider Demographics
NPI:1164109153
Name:FERGUSON, TAYLOR JANE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:JANE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:TARENTUM
Mailing Address - State:PA
Mailing Address - Zip Code:15084-1024
Mailing Address - Country:US
Mailing Address - Phone:724-859-8375
Mailing Address - Fax:
Practice Address - Street 1:116 LEECHBURG STREET
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656
Practice Address - Country:US
Practice Address - Phone:724-845-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine