Provider Demographics
NPI:1831907211
Name:FERDOUS, ASMA (FNP-C)
Entity type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:FERDOUS
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 1:256 DOUBLE GATE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8905
Mailing Address - Country:US
Mailing Address - Phone:860-993-6381
Mailing Address - Fax:
Practice Address - Street 1:256 DOUBLE GATE CT
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-8905
Practice Address - Country:US
Practice Address - Phone:860-993-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN300385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily