Provider Demographics
NPI:1922767193
Name:FORD, ASHLEY ANN (CNA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:FORD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:240 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-2338
Mailing Address - Country:US
Mailing Address - Phone:863-801-9706
Mailing Address - Fax:
Practice Address - Street 1:240 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-2338
Practice Address - Country:US
Practice Address - Phone:863-801-9706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNYFL0423541R376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL820888803Medicaid