Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | R062535 | MD |
N | 363LW0102X | Nurse Practitioner - Women's Health | R062535 | MD |
NPI | 1073614996 |
---|---|
Provider Name | Ms. Mary Elizabeth Ford |
First Address | Millersville, MD 21108-1454 |
Second Address | Annapolis, MD 21401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P63038 | (02) | MD |