Provider Demographics
NPI:1326632217
Name:FERGUSON, BROOKE E (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:E
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6990 S BEMIS ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-3646
Mailing Address - Country:US
Mailing Address - Phone:720-984-3034
Mailing Address - Fax:
Practice Address - Street 1:9695 S YOSEMITE ST STE 224
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2890
Practice Address - Country:US
Practice Address - Phone:303-265-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996225-NP207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine