Healthcare Provider Details
I. General information
NPI: 1760448286
Provider Name (Legal Business Name): JOANNE WARD N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 N GREENE ST
BALTIMORE MD
21201-1524
US
IV. Provider business mailing address
12417 HOOPER CT
FULTON MD
20759-9645
US
V. Phone/Fax
- Phone: 410-605-7000
- Fax: 410-605-7912
- Phone: 410-605-7000
- Fax: 410-605-7912
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | R041713 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: