Provider Demographics
NPI:1568356806
Name:FORD, VICTORIA (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 CHARRIER ST
Mailing Address - Street 2:
Mailing Address - City:MANSURA
Mailing Address - State:LA
Mailing Address - Zip Code:71350-4763
Mailing Address - Country:US
Mailing Address - Phone:318-264-8622
Mailing Address - Fax:
Practice Address - Street 1:457 W WADDIL ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2619
Practice Address - Country:US
Practice Address - Phone:800-462-0742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA240239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine