Marisa Emma Ford-mimms, is a
Licensed Practical Nurse based in Tawling, New York. Marisa Emma Ford-mimms is licensed to practice in New York (license number 305728-1) and her current practice location is
9 Reservoir Rd, Tawling, New York. She can be reached at her office (for appointments etc.) via phone at
(845) 855-5700.
NPI number for Marisa Emma Ford-mimms is 1073955704 and her current mailing address is 22 Davis St., Apt. 2, Beacon, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073955704.
Provider's Profile
| Full Name | Marisa Emma Ford-mimms |
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| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 9 Reservoir Rd, Tawling, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073955704
- Provider Enumeration Date: 07/23/2013
- Last Update Date: 07/23/2013
Medical Identifiers
Medical identifiers for Marisa Emma Ford-mimms such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073955704 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 305728-1 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marisa Emma Ford-mimms is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Marisa Emma Ford-mimms,
22 Davis St., Apt. 2,
Beacon, NY 12508
Ph: (845) 549-9982 | Marisa Emma Ford-mimms,
9 Reservoir Rd,
Tawling, NY 12564
Ph: (845) 855-5700 |
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