Provider Demographics
NPI:1013773704
Name:FERGUSON, LULA CAMILLE
Entity Type:Individual
Prefix:MS
First Name:LULA
Middle Name:CAMILLE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 KIMBERLY LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-2502
Mailing Address - Country:US
Mailing Address - Phone:479-799-9085
Mailing Address - Fax:
Practice Address - Street 1:80 KIMBERLY LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-2502
Practice Address - Country:US
Practice Address - Phone:479-799-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula