Grace P Ford, FNP-BC
Nurse Practitioner in Poplarville, MS. Individual provider (NPI-1).
NPI number1376815134
StatusActive
Last updated in NPPESNov 25, 2020
Details
- NPI
- 1376815134
- Entity type
- Individual (NPI-1)
- Name
- Grace P Ford
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2012
- Certification date
- Nov 25, 2020
- Last updated
- Nov 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 875721 | MS | Yes |
Other names
- Grace P O'Hara (Other Name)
Practice location
302 Highway 11 SPoplarville, MS 39470-2625
Phone 601-403-8283 · Fax 601-403-8283
Mailing address
305 W Moody StPoplarville, MS 39470-7338
Phone 601-795-4543 · Fax 601-795-4238
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