Provider Demographics
NPI:1972545911
Name:FORD, ELIZABETH STEVENSON (ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:STEVENSON
Last Name:FORD
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 MARCH CIR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4727
Mailing Address - Country:US
Mailing Address - Phone:561-790-4668
Mailing Address - Fax:
Practice Address - Street 1:1200 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PAHOKEE
Practice Address - State:FL
Practice Address - Zip Code:33476-1102
Practice Address - Country:US
Practice Address - Phone:561-924-0184
Practice Address - Fax:561-924-2516
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3069072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3094650 00Medicaid