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Individual

MRS. KIM C. FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN,FNP-BC

Contact information

Practice address
2500 CANYON RD,, BUILDING B UNITE 2, BULLHEAD CITY, AZ 86442
(928) 444-1444
(928) 444-1445
Mailing address
2500 CANYON RD BUILDING B UNITE 2, BULLHEAD CITY, AZ 86442
(928) 444-1444
(928) 444-1445

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP3148
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
468995
AZ
Enumeration date
01/27/2009
Last updated
03/19/2012
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