Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 14379 | NE |
NPI | 1003886813 |
---|---|
Provider Name | Dr. Linda B Ford |
First Address | Bellevue, NE 68123-4303 |
Second Address | Bellevue, NE 68123-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 20/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01353 | BLUE CROSS BLUE SHIELD (01) | NE |
47059317213 | (05) | NE |
B90806 | (02) | NE |