Provider Demographics
NPI:1881955268
Name:FORDE, GINNEL ANGELA (LPN)
Entity type:Individual
Prefix:MS
First Name:GINNEL
Middle Name:ANGELA
Last Name:FORDE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 LORING AVE
Mailing Address - Street 2:1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-5121
Mailing Address - Country:US
Mailing Address - Phone:347-496-1268
Mailing Address - Fax:
Practice Address - Street 1:1442 LORING AVE
Practice Address - Street 2:1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-5121
Practice Address - Country:US
Practice Address - Phone:347-496-1268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-02
Last Update Date:2012-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295703-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse