Provider Demographics
NPI:1871537019
Name:LEDFORD, AMY L (CNM)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 S ENOTA DR NE
Mailing Address - Street 2:SUITE Q
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2400
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:770-219-8440
Practice Address - Street 1:1498 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE D
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3874
Practice Address - Country:US
Practice Address - Phone:678-450-4757
Practice Address - Fax:678-450-4758
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN134376CNM176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA611211794BMedicaid
GA611211794BMedicaid
GAQ67258Medicare UPIN