Individual
JASON FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
31 N SAINT JOSEPH AVE, NILES, MI 49120
(269) 687-1879
(269) 683-0104
Mailing address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
(269) 687-1879
(269) 683-0104
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28165863
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
4704267914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200539770
—
IN
Enumeration date
05/15/2006
Last updated
06/24/2024
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