Provider Demographics
NPI:1285659326
Name:FERGUSON, NICOLE M (AUD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:M
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 MCLEOD DR S
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2827
Mailing Address - Country:US
Mailing Address - Phone:989-799-8620
Mailing Address - Fax:989-799-2664
Practice Address - Street 1:2551 MCLEOD DR S
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2827
Practice Address - Country:US
Practice Address - Phone:989-799-8620
Practice Address - Fax:989-799-2664
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501003395231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist