Provider Demographics
NPI:1447701313
Name:FERGUSON, TAYLOR MARIE (CNP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MARIE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:MARIE
Other - Last Name:HONAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6939 COX RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7595
Mailing Address - Country:US
Mailing Address - Phone:513-206-1460
Mailing Address - Fax:513-206-1479
Practice Address - Street 1:6939 COX RD
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45069-7595
Practice Address - Country:US
Practice Address - Phone:513-206-1460
Practice Address - Fax:513-206-1479
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.020039363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care