Provider Demographics
NPI:1144850645
Name:FERGUSON, JAZMINE NICOLE (RN, WHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:JAZMINE
Middle Name:NICOLE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3059 CATAWBA CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5759
Mailing Address - Country:US
Mailing Address - Phone:202-276-6519
Mailing Address - Fax:
Practice Address - Street 1:4700 ERIE ST
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1851
Practice Address - Country:US
Practice Address - Phone:301-345-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207404163W00000X, 363LW0102X
DCRN1034404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse