Individual
MRS. STACY LADEANE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
2712 MIDDLEBURG DR, SUITE 107, COLUMBIA, SC 29204-2415
(803) 256-4908
(803) 256-4900
Mailing address
100 S BOYLAN AVE, RALEIGH, NC 27603-1802
(919) 833-7526
(919) 832-9061
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN102954
GA
363LW0102X
Women's Health Nurse Practitioner
Primary
4036
SC
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
FOR104269443
GA
Other
Enumeration date
08/19/2011
Last updated
04/17/2015
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