Provider Demographics
NPI:1437266418
Name:FORD, STEPHANIE LYNNE (ARNP, PMHNP-BC, CPNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:FORD
Suffix:
Gender:F
Credentials:ARNP, PMHNP-BC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 SAINT CLAUDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-5338
Mailing Address - Country:US
Mailing Address - Phone:504-533-4999
Mailing Address - Fax:504-510-2708
Practice Address - Street 1:4209 SAINT CLAUDE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-5338
Practice Address - Country:US
Practice Address - Phone:504-533-4999
Practice Address - Fax:504-510-2708
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06312363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194784934Medicare UPIN