Healthcare Provider Details

I. General information

NPI: 1619894607
Provider Name (Legal Business Name): LASHONDA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 HART ST
CANTON MS
39046-4805
US

IV. Provider business mailing address

35372 MS HIGHWAY 35
VAIDEN MS
39176-5217
US

V. Phone/Fax

Practice location:
  • Phone: 662-229-7065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908558
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: