Individual
HOLLY F FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
7125 MURRELL RD, MELBOURNE, FL 32940-7999
(321) 242-8790
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 574-9179
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARPN9380144
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HW940Z
MEDICARE
FL
Enumeration date
09/19/2012
Last updated
09/10/2019
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