Provider Demographics
NPI:1255850459
Name:FERGUSON, CHERRELLE LAMIKA
Entity Type:Individual
Prefix:MRS
First Name:CHERRELLE
Middle Name:LAMIKA
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 1:125 LIONS CLUB RD APT 213
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-2137
Mailing Address - Country:US
Mailing Address - Phone:864-436-3256
Mailing Address - Fax:
Practice Address - Street 1:125 LIONS CLUB RD APT 213
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-2137
Practice Address - Country:US
Practice Address - Phone:864-436-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health