Provider Demographics
NPI:1871169664
Name:FORD, TYRIS D (DNP, NP-C, FNP-BC)
Entity type:Individual
Prefix:
First Name:TYRIS
Middle Name:D
Last Name:FORD
Suffix:
Gender:M
Credentials:DNP, NP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 H ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4706
Mailing Address - Country:US
Mailing Address - Phone:202-638-0750
Mailing Address - Fax:
Practice Address - Street 1:1331 H ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4706
Practice Address - Country:US
Practice Address - Phone:202-350-0801
Practice Address - Fax:202-989-1270
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1062404363LF0000X, 163W00000X, 363L00000X
MDR252235163W00000X, 363LF0000X
VA0024186113363LF0000X
DCR252235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner