Individual
AUTUMN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4002 24TH ST., LUBBOCK, TX 79410
(806) 725-0000
Mailing address
4002 24TH ST., LUBBOCK, TX 79410
(806) 725-0000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1075679
TX
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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