Individual
JEREMY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, NP-C
Contact information
Practice address
15609 SHIRLEY AVE, MAPLE HEIGHTS, OH 44137-4608
(216) 798-3294
Mailing address
15609 SHIRLEY AVE, MAPLE HEIGHTS, OH 44137-4608
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
025926
OH
363LG0600X
Gerontology Nurse Practitioner
025926
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
025926
OH
Other
Enumeration date
01/17/2020
Last updated
02/02/2021
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