MEDICARE: LADONNA FORD FNP-C

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
1	163WC0400X	Case Management Registered Nurse	201040855RN	WA
2	363LP2300X	Primary Care Nurse Practitioner	1177225	TX

General Provider Information

NPI Number	:	1649520578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LADONNA FORD FNP-C

Provider Business Mailing Address
First Line	:	1221 W AIRPORT FWY STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6208
Country	:	US
Telephone Number	:	214-777-2703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 W AIRPORT FWY STE 209
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6209
Country	:	US
Telephone Number	:	214-777-2703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	03/21/2025

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