STACY LADEANE FORD

COLUMBIA, SC
NPI1821378027
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LW0102X Nurse Practitioner, Women's Health
(Licence: SC  4036)
Additional Taxonomies363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: GA  FOR104269443)
363L00000X Nurse Practitioner
(Licence: GA  RN102954)
Enumeration Date2011-08-19
Last Update Date2015-04-17
Business Address
Mrs. STACY LADEANE FORD WHNP
2712 MIDDLEBURG DR SUITE 107
COLUMBIA, SC 29204-2415
Phone number: 803-256-4908
Mailing Address
Mrs. STACY LADEANE FORD WHNP
100 S BOYLAN AVE
RALEIGH, NC 27603-1802
Phone number: 919-833-7526