Individual
LIETZLE ANN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
28 ABBY RD, PALMYRA, VA 22963-2085
(540) 661-2533
Mailing address
28 ABBY RD, PALMYRA, VA 22963-2085
(434) 589-2278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0024176660
VA
363LF0000X
Family Nurse Practitioner
Primary
0024176660
VA
Other
Enumeration date
10/11/2018
Last updated
04/11/2023
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