MEDICARE: ELSA FORD FNP-C

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
1	363LF0000X	Family Nurse Practitioner	04890	RI

General Provider Information

NPI Number	:	1194676775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSA FORD FNP-C

Provider Business Mailing Address
First Line	:	39 CIRCLEWOOD DR
Second Line	:
City	:	COVENTRY
State	:	RI
Zip	:	02816-6646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 WASHINGTON ST
Second Line	:
City	:	COVENTRY
State	:	RI
Zip	:	02816-5476
Country	:	US
Telephone Number	:	401-822-2772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ ELSA FORD FNP-C” Practice Location

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