Individual
DEDRA DELANE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
22250 PROVIDENCE DR STE 202, SOUTHFIELD, MI 48075-6210
(248) 849-7400
(248) 849-7401
Mailing address
22250 PROVIDENCE DR STE 202, SOUTHFIELD, MI 48075-6210
(248) 849-7400
(248) 849-7401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704286031
MI
Other
Enumeration date
08/06/2020
Last updated
01/13/2021
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