MEDICARE: BRIEL WARD LPN, RN, BSN

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	164W00000X	Licensed Practical Nurse	160705M-IV	OH
2	163W00000X	Registered Nurse	526469	OH

General Provider Information

NPI Number	:	1720652076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIEL WARD LPN, RN, BSN

Provider Business Mailing Address
First Line	:	1927 CATALPA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-4701
Country	:	US
Telephone Number	:	513-884-9493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1927 CATALPA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-4701
Country	:	US
Telephone Number	:	513-884-9493
Fax Number	:

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

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	12/03/2024

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