Provider Demographics
NPI:1134771686
Name:FORD, KRISTI (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 NEW COVINGTON PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2593
Mailing Address - Country:US
Mailing Address - Phone:901-382-5256
Mailing Address - Fax:
Practice Address - Street 1:3950 NEW COVINGTON PIKE STE 300
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2593
Practice Address - Country:US
Practice Address - Phone:901-382-5256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26169363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner