Individual
RENAY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900
(870) 534-4906
Mailing address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900
(870) 534-4906
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R074378
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180635526
—
AR
Enumeration date
07/10/2014
Last updated
07/10/2014
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