Provider Demographics
NPI:1184262776
Name:FORD, ANDREW TIPTON (CRNA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:TIPTON
Last Name:FORD
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 NORTH DUKE STREET
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-4676
Mailing Address - Fax:717-544-7157
Practice Address - Street 1:555 NORTH DUKE STREET
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-4676
Practice Address - Fax:717-544-7157
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-15
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN643436367500000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered