Provider Demographics
NPI:1629195961
Name:FERGUSON, NANCY J (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1799
Mailing Address - Street 2:
Mailing Address - City:GRANTHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03753-1799
Mailing Address - Country:US
Mailing Address - Phone:603-843-8913
Mailing Address - Fax:866-673-9513
Practice Address - Street 1:418 ROAD ROUND THE LAKE
Practice Address - Street 2:
Practice Address - City:GRANTHAM
Practice Address - State:NH
Practice Address - Zip Code:03753-1799
Practice Address - Country:US
Practice Address - Phone:603-843-8913
Practice Address - Fax:866-673-9513
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04505700207P00000X, 207Q00000X
PAMD437071207P00000X, 207Q00000X, 261QU0200X
NH180258207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care