Provider Demographics
NPI:1578947735
Name:FERGUSON, MICHELLE MARIE (RN, MSN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARIE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:MANGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4551 YADKIN RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-3421
Mailing Address - Country:US
Mailing Address - Phone:866-942-7762
Mailing Address - Fax:910-401-0845
Practice Address - Street 1:4551 YADKIN RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3421
Practice Address - Country:US
Practice Address - Phone:866-942-7762
Practice Address - Fax:910-401-0845
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily