Provider Demographics
NPI:1689896987
Name:ALFORD, IDA ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:IDA
Middle Name:ANN
Last Name:ALFORD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:145 SCHOOL STREET
Mailing Address - City:SHELDON SPRINGS
Mailing Address - State:VT
Mailing Address - Zip Code:05485-0052
Mailing Address - Country:US
Mailing Address - Phone:802-933-5912
Mailing Address - Fax:
Practice Address - Street 1:145 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:SHELDON SPRINGS
Practice Address - State:VT
Practice Address - Zip Code:05485-0052
Practice Address - Country:US
Practice Address - Phone:802-933-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT025-0007810164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse