MEDICARE: KRISTI 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	AP10451	AZ

General Provider Information

NPI Number	:	1316458508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI FORD FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 6423
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85246-6423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6525 W SACK DR STE 201
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-7106
Country	:	US
Telephone Number	:	602-337-8500
Fax Number	:	602-337-8151

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

Provider Enumeration Date	:	10/16/2017
Last Update Date	:	01/30/2023

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Directions to “ KRISTI FORD FNP-C” Practice Location

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