Provider Demographics
NPI:1891130753
Name:FORD, ANITA JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:JO
Last Name:FORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 BOGUS RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-9387
Mailing Address - Country:US
Mailing Address - Phone:740-505-8181
Mailing Address - Fax:
Practice Address - Street 1:1072 BOGUS RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-9387
Practice Address - Country:US
Practice Address - Phone:740-505-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN346491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse