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General NPI Number Information
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NPI Number | 1952441206
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Entity Type | Individual
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Provider Name | CONNIE BIERLY FORD CNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2148 E MAIN ST CORNER CARE CLINIIC
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City | SPRINGFIELD
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State | OH
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Zip | 45503-4956
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Country | US
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Telephone | 937-525-0455
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Fax |
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Provider Business Mailing Address
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Address Line | 240 ARDMORE DR
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City | CEDARVILLE
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State | OH
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Zip | 45314-9594
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Country | US
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Telephone | 937-766-1490
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA 07481-NP
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License Number State | OH
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