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General NPI Number Information
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NPI Number | 1053749838
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Entity Type | Individual
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Provider Name | STEPHANIE DRAZER FORD APRN
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Gender | Female
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1105 GLENDALE BLVD
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City | VALPARAISO
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State | IN
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Zip | 46383-3724
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Country | US
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Telephone | 219-384-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 2931 GLENWOOD BEACH TRL
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City | PORTER
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State | IN
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Zip | 46304-3422
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Country | US
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Telephone | 219-384-8181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71017342
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License Number State | IN
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