Provider Demographics
NPI:1477331932
Name:FERGUSON, KELSEY LEIGH (RRT)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LEIGH
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 DRESSER AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-4980
Mailing Address - Country:US
Mailing Address - Phone:608-513-9841
Mailing Address - Fax:
Practice Address - Street 1:1027 DRESSER AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-4980
Practice Address - Country:US
Practice Address - Phone:608-513-9841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4112-28227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered