Provider Demographics
NPI:1023548351
Name:FERGUSON, TRACY A (FNP-C)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:A
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 1:3730 DUNCAN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-4908
Mailing Address - Country:US
Mailing Address - Phone:706-778-7602
Mailing Address - Fax:
Practice Address - Street 1:225 ADAMS DR STE A
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4578
Practice Address - Country:US
Practice Address - Phone:706-778-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily