Provider Demographics
NPI:1942982459
Name:FERGUSON, TAYLOR ELISE (FNP-C)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELISE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SW 7TH ST UNIT 13
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-4532
Mailing Address - Country:US
Mailing Address - Phone:712-899-7881
Mailing Address - Fax:
Practice Address - Street 1:555 SW 7TH ST UNIT 13
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-4532
Practice Address - Country:US
Practice Address - Phone:712-899-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA175719363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care