Individual
MARLENE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
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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