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NPI Code Detail

MEDICARE: MRS. ROSALVA FORD LPN

MEDICARE: MRS. ROSALVA FORD LPN
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
1164W00000XLicensed Practical Nurse149163-M-IVOH

General Provider Information

NPI Number : 1477061182
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSALVA FORD LPN
Provider Business Mailing Address
First Line : 800 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5256
Country : US
Telephone Number : 419-352-5387
Fax Number :
Provider Business Practice Location Address
First Line : 800 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5256
Country : US
Telephone Number : 419-352-5387
Fax Number : 419-352-5387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2018
Last Update Date : 01/16/2018

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Directions to “ MRS. ROSALVA FORD LPN” Practice Location

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