Provider Demographics
NPI:1811069594
Name:FERGUSON, CECELIA DENISE (RN,BSN)
Entity type:Individual
Prefix:MISS
First Name:CECELIA
Middle Name:DENISE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11255 KETTERING PL
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1578
Mailing Address - Country:US
Mailing Address - Phone:301-728-4651
Mailing Address - Fax:301-336-5349
Practice Address - Street 1:11255 KETTERING PL
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1578
Practice Address - Country:US
Practice Address - Phone:301-728-4651
Practice Address - Fax:301-336-5349
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN47490163W00000X, 163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WN0300XNursing Service ProvidersRegistered NurseNephrology