MEDICARE: MRS. JENNIFER FORD LPN

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	163W00000X	Registered Nurse	N31346	NY
2	164W00000X	Licensed Practical Nurse	253566	NY

General Provider Information

NPI Number	:	1457683930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER FORD LPN

Provider Business Mailing Address
First Line	:	2002 MONROE AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1521
Country	:	US
Telephone Number	:	516-661-9087
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 MONROE AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1521
Country	:	US
Telephone Number	:	516-661-9087
Fax Number	:

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

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	03/11/2026

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