Provider Demographics
NPI:1366245607
Name:FORD, MONICA (FNP-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 FORTRESS COURSE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2508
Mailing Address - Country:US
Mailing Address - Phone:808-551-7916
Mailing Address - Fax:
Practice Address - Street 1:3150 N TENAYA WAY STE 520
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0448
Practice Address - Country:US
Practice Address - Phone:702-962-2100
Practice Address - Fax:702-962-5620
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV849256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner