Basic Information
| Provider Information | |||||||||
| NPI: | 1447386586 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERGUSON | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 REBECCA DR | ||||||||
| Address2: | |||||||||
| City: | PHOENIXVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194604705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109839773 | ||||||||
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| Practice Location | |||||||||
| Address1: | SIXTH AVENUE AND SPRUCE STREET | ||||||||
| Address2: | THE READING HOSPITAL AND MEDICAL CENTER | ||||||||
| City: | READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196126052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2007 | ||||||||
| LastUpdateDate: | 11/02/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA000631L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.