| Doctor Name: | GRACE P FORD |
| NPI Number: | 1376815134 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | R875721 |
| Business Practice Address: | 1222 S Main St Poplarville, MS - 394703318 |
| Business Phone Number: | 6017959320 |
| Business Fax Number: | 6017959876 |
| Mailing Address: | 1434 Central Ave E, WIGGINS |
| State: | MS |
| Postal Code: | 395779602 |
| Phone Number: | 6019285999 |
| Fax Number: | 6019289393 |
| NPI Enumeration Date: | 02/08/2012 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R875721 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |