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General NPI Number Information
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NPI Number | 1619383395
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Entity Type | Individual
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Provider Name | JEANNA ANN FORD APRN
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Gender | Female
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1823 CAMINO DE SALUD
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3782
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Country | US
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Telephone | 505-688-6921
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Fax | 505-925-4594
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Provider Business Mailing Address
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Address Line | 6608 SALT CEDAR TRL NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2384
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Country | US
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Telephone | 505-585-1865
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 82623
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | CNS-00261
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License Number State | NM
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