Provider Demographics
NPI:1720191398
Name:FERGUSON, ANNA DENISE (ATC, CSCS)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:DENISE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 W ASHLEY PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-3367
Mailing Address - Country:US
Mailing Address - Phone:520-481-8413
Mailing Address - Fax:
Practice Address - Street 1:1 NATIONAL CHAMPIONSHIP DR
Practice Address - Street 2:MKN108
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0096
Practice Address - Country:US
Practice Address - Phone:520-621-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer