MEDICARE: MS. CHASIDY LYNN WARD APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F06201365	SC

General Provider Information

NPI Number	:	1235755984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHASIDY LYNN WARD APRN, FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 3439
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-0439
Country	:	US
Telephone Number	:	843-497-5929
Fax Number	:

Provider Business Practice Location Address
First Line	:	5023 CAROLINA FOREST BLVD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-3578
Country	:	US
Telephone Number	:	843-497-5929
Fax Number	:	843-839-4448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2020
Last Update Date	:	08/21/2024

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