Provider Demographics
NPI:1376833319
Name:FORD JOHNSON, NINA SHEREE (MD)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:SHEREE
Last Name:FORD JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013C AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-2201
Mailing Address - Country:US
Mailing Address - Phone:251-435-5437
Mailing Address - Fax:251-435-6744
Practice Address - Street 1:4013C AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-2201
Practice Address - Country:US
Practice Address - Phone:251-435-5437
Practice Address - Fax:251-435-6744
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10030754208000000X
AL30958208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics