Individual
LAURA CATHERINE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
52375 N MAIN ST, MATTAWAN, MI 49071-9332
(269) 668-3348
(269) 668-7702
Mailing address
52375 N MAIN ST, MATTAWAN, MI 49071-9332
(269) 668-3348
(269) 668-7702
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704134722
MI
363LW0102X
Women's Health Nurse Practitioner
4704134722
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114987799
—
MI
Enumeration date
07/20/2005
Last updated
11/19/2014
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