Provider Demographics
NPI:1326579574
Name:RAMSEY-FORD, MARIAN (NP-C)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:RAMSEY-FORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 649
Mailing Address - Street 2:
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-0649
Mailing Address - Country:US
Mailing Address - Phone:928-729-8000
Mailing Address - Fax:
Practice Address - Street 1:6 BASSWOOD RD
Practice Address - Street 2:
Practice Address - City:PARAJE
Practice Address - State:NM
Practice Address - Zip Code:87007-1004
Practice Address - Country:US
Practice Address - Phone:505-431-0711
Practice Address - Fax:833-396-0978
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22620363LP2300X
IN71006974A363LP2300X
AZ226220363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care