Healthcare Provider Details

I. General information

NPI: 1174950109
Provider Name (Legal Business Name): PATRICIA WARD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 W 2ND PL STE 450
LAKEWOOD CO
80228-1719
US

IV. Provider business mailing address

PO BOX 911057
DENVER CO
80291-1057
US

V. Phone/Fax

Practice location:
  • Phone: 303-825-1234
  • Fax: 720-321-8121
Mailing address:
  • Phone: 303-486-5504
  • Fax: 303-486-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP 0990898
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: