Healthcare Provider Details

I. General information

NPI: 1679141626
Provider Name (Legal Business Name): CATHERINE MARIE FORD MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE MARIE REED

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E MAIN ST
HULBERT OK
74441-8902
US

IV. Provider business mailing address

1401 W LOCUST ST STE 102
STILWELL OK
74960-3276
US

V. Phone/Fax

Practice location:
  • Phone: 918-772-2879
  • Fax:
Mailing address:
  • Phone: 918-696-4064
  • Fax: 918-696-4170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF11200878
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200505
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: