Individual
LISTINA FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4149 HIGHLINE BLVD, SUITE 380, OKLAHOMA CITY, OK 73108-2103
(405) 942-7650
(405) 942-7686
Mailing address
1403 MAGNOLIA LN, MIDWEST CITY, OK 73110-4819
(405) 471-7670
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
50218
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040
—
OK
Enumeration date
08/01/2011
Last updated
08/01/2011
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