Individual
VINCENT EDWARD FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
9508 S 43RD AVE, LAVEEN, AZ 85339-7746
(919) 923-3584
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
256475
AZ
390200000X
Student in an Organized Health Care Education/Training Program
0001250252
VA
Other
Enumeration date
12/07/2016
Last updated
05/04/2021
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