MEDICARE: MRS. SARAH ELIZABETH FORD APN

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	20900	TN

General Provider Information

NPI Number	:	1780044016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH ELIZABETH FORD APN

Provider Business Mailing Address
First Line	:	862 CALLEN LN NW STE 110
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-7020
Country	:	US
Telephone Number	:	423-331-5025
Fax Number	:	833-450-6211

Provider Business Practice Location Address
First Line	:	862 CALLEN LN NW STE 110
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-7020
Country	:	US
Telephone Number	:	423-331-5025
Fax Number	:	833-450-6211

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

Provider Enumeration Date	:	02/29/2016
Last Update Date	:	09/18/2025

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