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NPI Code Detail

MEDICARE: TERESA TRIPP FORD FNP

MEDICARE: TERESA TRIPP FORD FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN201917GA

General Provider Information

NPI Number : 1023580420
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA TRIPP FORD FNP
Provider Business Mailing Address
First Line : 503 E COLLEGE AVE
Second Line :
City : ASHBURN
State : GA
Zip : 31714-5322
Country : US
Telephone Number : 229-457-1313
Fax Number :
Provider Business Practice Location Address
First Line : 317 E WASHINGTON AVE
Second Line :
City : ASHBURN
State : GA
Zip : 31714-5248
Country : US
Telephone Number : 229-567-4414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2018
Last Update Date : 07/20/2022

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Directions to “ TERESA TRIPP FORD FNP” Practice Location

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