Provider Demographics
NPI:1346589868
Name:FORD, CATHY SHEA (RNFA)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SHEA
Last Name:FORD
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8051 S EMERSON AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8600
Mailing Address - Country:US
Mailing Address - Phone:317-528-7650
Mailing Address - Fax:
Practice Address - Street 1:8051 S EMERSON AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8600
Practice Address - Country:US
Practice Address - Phone:317-528-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28079516A163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery