Individual
JAN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 MAIN ST STE 1, LANOKA HARBOR, NJ 08734-2228
(732) 719-1920
(732) 719-1920
Mailing address
500 MAIN ST STE 1, LANOKA HARBOR, NJ 08734-2228
(732) 719-1920
(732) 719-1920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
26NJ00922600
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00922600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00922600
FOR COMMERCIAL INSURANCES
NJ
05
—
26NJ00922600
—
NJ
Enumeration date
05/21/2019
Last updated
08/15/2022
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