MRS. STEPHANIE R FORDE (NPI# 1831759141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831759141 |
Entity Type | Individual |
Full Name | MRS. STEPHANIE R FORDE |
Other Name | MS. STEPHANIE R GREEN |
Practice Address |
12379 Glimmer Way Jacksonville FL 32219-1867 |
Practice Telephone | 9043147411 |
Practice Fax Number | 9047512200 |
Mailing Telephone | 9043147411 |
Mailing Fax Number | 9047512200 |
Enumeration Date | 2019-06-18 |
Last Update Date | 2019-06-18 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility |
Street Address |
12379 GLIMMER WAY |
City | JACKSONVILLE |
State | FL |
Zip Code | 32219-1867 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902182447 | Beatrice E Hall | Technician | 5838 Soutel Dr., Jacksonville, FL 32219 | 2011-10-28 |
1437173697 | Bennie Clark Jr. | Dentist | 5475 Soutel Drive, Jacksonville, FL 32219 | 2006-07-27 |
1801842679 | Susan E. Kurner | Counselor | 10149 Fox Lake Ct, Jacksonville, FL 32219-1693 | 2006-05-25 |
1841629243 | Latonia Delores Simmons | Day Training, Developmentally Disabled Services | 12428 Cadley Cir, Jacksonville, FL 32219-1861 | 2013-11-06 |
1114495512 | La Assistant Services | Home Health Aide | 12428 Cadley Cir, Jacksonville, FL 32219-1861 | 2018-11-05 |
1700372869 | Valerie M Vinson-anderson | In Home Supportive Care | 6751 Langford St, Jacksonville, FL 32219-1875 | 2018-07-02 |
1821528860 | Samaiyah Harris | Adult Companion | 6967 Sandle Dr, Jacksonville, FL 32219-1884 | 2017-06-13 |
1023508595 | Present Help Companion Services, LLC | Respite Care | 6967 Sandle Dr, Jacksonville, FL 32219-1884 | 2018-05-10 |
1629635420 | Kimberly Walker | Registered Nurse | 8921 Merseyside Ave, Jacksonville, FL 32219-2374 | 2019-05-28 |
1649808197 | Leaanne Griffis | Registered Nurse | 10482 New Kings Rd, Jacksonville, FL 32219-2418 | 2020-03-31 |
Find all providers in zip 32219 |
Taxonomy Code | 3747P1801X |
Grouping | Nursing Service Related Providers |
Classification | Technician |
Specialization | Personal Care Attendant |
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
Notes: [7/1/2003: definition added] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972141224 | Ami B Kowalski | Technician | 8161 Crosswind Rd, Jacksonville, FL 32244-5453 | 2019-12-17 |
1104462423 | Geoffrey C Lane | Technician | 4216 Old Mill Cove Trl W, Jacksonville, FL 32277-1582 | 2019-11-21 |
1093279572 | Andrew Jay Jackson | Technician | 125 County Road 4209, Jacksonville, TX 75766-5574 | 2019-01-29 |
1790259729 | Juanita R. Cooks | Technician | 3224 Liberty Cir, Jacksonville, FL 32206-2101 | 2019-01-12 |
1669945606 | Suzie Pennington | Technician | 7541 Fawn Lake Dr N, Jacksonville, FL 32256-3665 | 2019-01-02 |
1518439876 | Angela Rand | Technician | 1710 Naldo Ave, Jacksonville, FL 32207-3138 | 2018-12-27 |
1366913394 | Sandra Prince Alvey | Technician | 2829 Seville Ct, Jacksonville, FL 32207-4622 | 2018-12-17 |
1235600321 | Angela Justina Mcdonald | Technician | 3047 Mikris Dr E, Jacksonville, FL 32225-7607 | 2018-12-16 |
1306317359 | Lauren Renee Simao | Technician | 1665 Cedar Bay Rd, Jacksonville, FL 32218-4971 | 2018-12-16 |
1861976714 | Tomilko Adina Burden | Technician | 5984 Windsor Forest Dr Apt 5, Jacksonville, FL 32210-7802 | 2018-09-17 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32219 |
Please comment or provide details below to improve the information on MRS. STEPHANIE R FORDE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.