| Doctor Name: | MS. CANDACE FERGUSON |
| NPI Number: | 1265449714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 60250 |
| Business Practice Address: | 129 Kansas Ave Walsenburg, CO - 810891818 |
| Business Phone Number: | 7197385200 |
| Business Fax Number: | 7197382732 |
| Mailing Address: | 129 Kanas Avenue, WALSENBURG |
| State: | CO |
| Postal Code: | 810899524 |
| Phone Number: | 7197385200 |
| Fax Number: | 7197382732 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 01/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 60250 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |