Provider Demographics
NPI:1720847247
Name:FORD, JESSICA MARY
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MARY
Last Name:FORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CANAL CIR APT 402
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3685
Mailing Address - Country:US
Mailing Address - Phone:551-206-4475
Mailing Address - Fax:
Practice Address - Street 1:44 CANAL CIR APT 402
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3685
Practice Address - Country:US
Practice Address - Phone:551-206-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula