Provider Demographics
NPI:1619351939
Name:FORD, KATHYRN (RRT)
Entity Type:Individual
Prefix:
First Name:KATHYRN
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 CAPE HENLOPEN DR
Mailing Address - Street 2:UNIT 102
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1170
Mailing Address - Country:US
Mailing Address - Phone:302-381-2584
Mailing Address - Fax:
Practice Address - Street 1:53 CAPE HENLOPEN DR
Practice Address - Street 2:UNIT 102
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1170
Practice Address - Country:US
Practice Address - Phone:302-381-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC9-00002772279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care