Provider Demographics
NPI:1255301776
Name:FERGUSON, BRIDGETTE DIANE (FNP, CNS)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:DIANE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:FNP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 KAVEH CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3681
Mailing Address - Country:US
Mailing Address - Phone:757-553-8897
Mailing Address - Fax:
Practice Address - Street 1:695 KINKAID RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21402-1006
Practice Address - Country:US
Practice Address - Phone:410-293-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR150910163WP2201X, 363LC1500X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health