Provider Demographics
NPI:1356916597
Name:FORD, WILLIAM RICHARD III (APRN)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:FORD
Suffix:III
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:RICHARD
Other - Last Name:FORD
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:1945 WREN ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2377
Mailing Address - Country:US
Mailing Address - Phone:775-313-6368
Mailing Address - Fax:
Practice Address - Street 1:781 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1320
Practice Address - Country:US
Practice Address - Phone:775-398-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV841817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily