Individual
KADEGDRA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 S DIVISION ST, BLYTHEVILLE, AR 72315-5445
(870) 763-2390
Mailing address
1201 S DIVISION ST, BLYTHEVILLE, AR 72315-5445
(870) 763-2390
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L059452
AR
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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