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NPI Code Detail

MEDICARE: TEAONDRA M FORD ARNP

MEDICARE: TEAONDRA M FORD ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP9272567FL
2363LF0000XFamily Nurse PractitionerGAA-NP001429GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467887059
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEAONDRA M FORD ARNP
Provider Business Mailing Address
First Line : PO BOX 740015
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0015
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1631 GORDON HWY STE 17A
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-2229
Country : US
Telephone Number : 706-230-7006
Fax Number : 762-257-7442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2013
Last Update Date : 12/02/2024

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Directions to “ TEAONDRA M FORD ARNP” Practice Location

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