Individual
MARLENE FORD
Active
Individual
MARLENE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28137180
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
4704355036
MI
Other
Enumeration date
05/15/2006
Last updated
12/03/2019
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