Healthcare Provider Details

I. General information

NPI: 1548521107
Provider Name (Legal Business Name): ANGEL WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6856 EASTERN AVE NW SUITE 350
WASHINGTON DC
20012-2165
US

IV. Provider business mailing address

4305 MIDTOWN SQ APT 3038
CAMP SPRINGS MD
20746-4432
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-0211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberW630067067330
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: