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NPI Code Detail

MEDICARE: CORI LEE WARD APRN, PMHNP

MEDICARE: CORI LEE WARD APRN, PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner202011098NP-PPOR
2363LF0000XFamily Nurse Practitioner6267411-4405UT

General Provider Information

NPI Number : 1518132216
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORI LEE WARD APRN, PMHNP
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5373 S GREEN ST STE 400
Second Line :
City : MURRAY
State : UT
Zip : 84123-4740
Country : US
Telephone Number : 833-442-2670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2008
Last Update Date : 09/23/2024

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