Healthcare Provider Details

I. General information

NPI: 1477477487
Provider Name (Legal Business Name): HOLLY AMANDA FORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S MONROE ST
MINDEN LA
71055-3357
US

IV. Provider business mailing address

223 SHANGRILA DR
CHOUDRANT LA
71227-3311
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-3425
  • Fax:
Mailing address:
  • Phone: 318-497-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number247697
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: