Healthcare Provider Details

I. General information

NPI: 1558012989
Provider Name (Legal Business Name): NICOLE MARIE WARD APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2466 E CHESTNUT AVE STE 2
VINELAND NJ
08361-8486
US

IV. Provider business mailing address

PO BOX 95000 LB#7895
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 856-213-9500
  • Fax: 856-221-4099
Mailing address:
  • Phone: 856-205-7070
  • Fax: 856-205-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01257800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: