Healthcare Provider Details

I. General information

NPI: 1780044016
Provider Name (Legal Business Name): SARAH ELIZABETH FORD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

862 CALLEN LN NW STE 110
CLEVELAND TN
37312-7020
US

IV. Provider business mailing address

862 CALLEN LN NW STE 110
CLEVELAND TN
37312-7020
US

V. Phone/Fax

Practice location:
  • Phone: 423-331-5025
  • Fax: 833-450-6211
Mailing address:
  • Phone: 423-331-5025
  • Fax: 833-450-6211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20900
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: