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TABITHA FORD

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1538768965

Individual Registrant:
 TABITHA  FORD 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
110 SHORTER ST LOT 9  TY TY, GA 31795-3179 US
Tel: 229-256-7374  Fax: --

Contact information for business:
110 SHORTER ST LOT 9  TY TY, GA 31795-3179 US
Tel: 229-256-7374  Fax: --

Registration Information:
NPI: 1538768965
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
GARN173276

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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