| NPI | 1598138505 |
|---|---|
| Former Name | AMANDA KIMBROUGH FORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173017) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0017142572) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 363LP0808X) | |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2019-06-28 |