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NPI Code Detail

MEDICARE: KEILAH B FORD DNP, FNP-C, PMHNP-BC

MEDICARE: KEILAH B FORD DNP, FNP-C, PMHNP-BC
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 PractitionerAP127727TX
2363LP0808XPsychiatric/Mental Health Nurse PractitionerC-RXN.0002130-C-NPCO
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAP127727TX
4363LF0000XFamily Nurse PractitionerC-RXN.0002130-C-NPCO

General Provider Information

NPI Number : 1871980730
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEILAH B FORD DNP, FNP-C, PMHNP-BC
Provider Business Mailing Address
First Line : 13810 CHAMPION FOREST DR STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1883
Country : US
Telephone Number : 601-334-6858
Fax Number : 346-553-8456
Provider Business Practice Location Address
First Line : 13810 CHAMPION FOREST DR STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1883
Country : US
Telephone Number : 281-436-9444
Fax Number : 346-553-8456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2015
Last Update Date : 08/02/2024

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