Healthcare Provider Details

I. General information

NPI: 1780442046
Provider Name (Legal Business Name): FAITH FORDJOUR APRN, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 MORRISON ST
LITHOPOLIS OH
43136-0165
US

IV. Provider business mailing address

630 MORRISON ST
LITHOPOLIS OH
43136-0165
US

V. Phone/Fax

Practice location:
  • Phone: 646-683-5928
  • Fax:
Mailing address:
  • Phone: 646-683-5928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0038238
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: