Healthcare Provider Details

I. General information

NPI: 1245785765
Provider Name (Legal Business Name): JOANNA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HAVANA ST
AURORA CO
80014-1618
US

IV. Provider business mailing address

7925 CARR DR
ARVADA CO
80005-4421
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-3045
  • Fax:
Mailing address:
  • Phone: 720-938-0276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0198863
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: