Provider Demographics
NPI:1396114583
Name:FORD, MISTY E (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:E
Last Name:FORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:MISTY
Other - Middle Name:E
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:247 E WATT ST
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-2236
Mailing Address - Country:US
Mailing Address - Phone:865-984-2001
Mailing Address - Fax:
Practice Address - Street 1:247 E WATT ST
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2236
Practice Address - Country:US
Practice Address - Phone:865-984-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily