| NPI | 1942620372 |
|---|---|
| Former Name | AMANDA J FORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277000592) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277000592) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2022-08-22 |