Provider Demographics
NPI:1609573666
Name:FERGUSON, NATALIE PAGANO (DNP FNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:PAGANO
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 BELL BLVD APT 416
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1651
Mailing Address - Country:US
Mailing Address - Phone:718-483-2440
Mailing Address - Fax:
Practice Address - Street 1:1670 BELL BLVD APT 416
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1651
Practice Address - Country:US
Practice Address - Phone:718-483-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily