Provider Demographics
NPI:1467995365
Name:FORD, EMILY (ARNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 S TUTTLE AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3132
Mailing Address - Country:US
Mailing Address - Phone:941-799-5753
Mailing Address - Fax:888-814-0877
Practice Address - Street 1:1617 S TUTTLE AVE STE 1A
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3132
Practice Address - Country:US
Practice Address - Phone:941-799-5753
Practice Address - Fax:888-814-0877
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9184961363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology