Provider Demographics
NPI:1881330264
Name:FERGUSON, BRITTNEY MICHELLE
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:MICHELLE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 GREEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70811-1244
Mailing Address - Country:US
Mailing Address - Phone:225-716-2919
Mailing Address - Fax:
Practice Address - Street 1:11814 MARKET PLACE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-6084
Practice Address - Country:US
Practice Address - Phone:225-223-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator