Provider Demographics
NPI:1467995365
Name:FORD, EMILY (ARNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 W SWANN AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4038
Mailing Address - Country:US
Mailing Address - Phone:813-551-3540
Mailing Address - Fax:813-551-3541
Practice Address - Street 1:2919 W SWANN AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4038
Practice Address - Country:US
Practice Address - Phone:813-551-3540
Practice Address - Fax:813-551-3541
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9184961363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology