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General NPI Number Information
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NPI Number | 1467887059
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Entity Type | Individual
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Provider Name | TEAONDRA M FORD ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1631 GORDON HWY STE 17A
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City | AUGUSTA
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State | GA
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Zip | 30906-2229
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Country | US
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Telephone | 706-230-7006
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Fax | 762-257-7442
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Provider Business Mailing Address
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Address Line | PO BOX 740015
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City | ATLANTA
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State | GA
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Zip | 30374-0015
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Country | US
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Telephone | 312-733-9730
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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 | ARNP9272567
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP001429
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License Number State | GA
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