Provider Demographics
NPI:1912151416
Name:FERGUSON, LUCY L (LM, CPM)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:L
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20790 SIBLEY RD
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72768-9001
Mailing Address - Country:US
Mailing Address - Phone:479-298-3409
Mailing Address - Fax:
Practice Address - Street 1:20790 SIBLEY RD
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72768-9001
Practice Address - Country:US
Practice Address - Phone:479-298-3409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR012002175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay