Provider Demographics
NPI:1619037132
Name:FERGUSON, ANGELA CARSON (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CARSON
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:RENEE
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX K
Mailing Address - Street 2:
Mailing Address - City:SWEET BRIAR
Mailing Address - State:VA
Mailing Address - Zip Code:24595
Mailing Address - Country:US
Mailing Address - Phone:434-381-6140
Mailing Address - Fax:434-381-6375
Practice Address - Street 1:134 CHAPEL LANE
Practice Address - Street 2:
Practice Address - City:SWEET BRIAR
Practice Address - State:VA
Practice Address - Zip Code:24595
Practice Address - Country:US
Practice Address - Phone:434-381-6140
Practice Address - Fax:434-381-6375
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-12-11
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-09-02
Provider Licenses
StateLicense IDTaxonomies
VA0024165807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily