Provider Demographics
NPI:1689219727
Name:FORDE, ISABELLE KATHERINE
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:KATHERINE
Last Name:FORDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NH
Mailing Address - Zip Code:03849-0073
Mailing Address - Country:US
Mailing Address - Phone:603-387-7530
Mailing Address - Fax:
Practice Address - Street 1:421 COLBY HILL ROAD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NH
Practice Address - Zip Code:03849-0384
Practice Address - Country:US
Practice Address - Phone:603-387-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program