Provider Demographics
NPI:1326058595
Name:FERGUSON, BARBARA BRENNAN (PHD APN C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BRENNAN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PHD APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 BEAUVOIR AVENUE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07902-3533
Mailing Address - Country:US
Mailing Address - Phone:918-522-4882
Mailing Address - Fax:908-522-5269
Practice Address - Street 1:99 BEAUVOIR AVENUE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07902-3533
Practice Address - Country:US
Practice Address - Phone:918-522-4882
Practice Address - Fax:908-522-5269
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05955200364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health