Provider Demographics
NPI:1730455890
Name:FERGUSON, MICHELLE ANN (ACNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 LIMESTONE PKWY STE 222
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2567
Mailing Address - Country:US
Mailing Address - Phone:770-219-8888
Mailing Address - Fax:770-219-8887
Practice Address - Street 1:2150 LIMESTONE PKWY STE 222
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2567
Practice Address - Country:US
Practice Address - Phone:770-219-8888
Practice Address - Fax:770-219-8887
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2025-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272332363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004719900Medicaid
FL004719900Medicaid