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Individual

BEVERLY L FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
595 PETER JEFFERSON PKWY, CHARLOTTESVILLE, VA 22911-4627
(434) 982-8504
(434) 982-8501
Mailing address
PO BOX 11647, DAYTONA BEACH, FL 32120-1647
(386) 274-7800
(386) 274-7801

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0024167141
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001097856
LICENSE RN
VI
01
0017138706
LICENSED NP
VA
01
0024167141
VA STATE LICENSE
VA
Enumeration date
11/21/2006
Last updated
09/18/2008
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