Provider Demographics
NPI:1255903803
Name:FERGUSON, KERSTIN LEAH ASHBY (RN, FNP)
Entity type:Individual
Prefix:
First Name:KERSTIN
Middle Name:LEAH ASHBY
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:KERSTIN
Other - Middle Name:LEAH
Other - Last Name:ASHBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20601 WEST PAOLI LANE
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95736
Mailing Address - Country:US
Mailing Address - Phone:530-637-4025
Mailing Address - Fax:
Practice Address - Street 1:20601 W. PAOLI LANE
Practice Address - Street 2:
Practice Address - City:WEIMAR
Practice Address - State:CA
Practice Address - Zip Code:95736
Practice Address - Country:US
Practice Address - Phone:530-637-4025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily