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NICOLE FORD NP-C
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1588642771
Individual Registrant: NICOLE FORD NP-C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
11 CHARLIE MORRIS RD COLBERT, GA 30628-2445 US
Tel: 706-788-2127 Fax: 706-788-2815
Tel: 706-788-2127 Fax: 706-788-2815
Contact information for business:
PO BOX 459 COLBERT, GA 30628-0459 US
Tel: 706-788-3234 Fax: --
Tel: 706-788-3234 Fax: --
Registration Information:
NPI: 1588642771
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | GA | RN139406 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 717156962A | GA | 05 |
