Healthcare Provider Details

I. General information

NPI: 1104253665
Provider Name (Legal Business Name): LINDA WARD CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA WARD CNP

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 07/21/2022
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30680 BAINDRIDGE RD
SOLON OH
44139
US

IV. Provider business mailing address

6688 METRO PARK DR
MAYFIELD VILLAGE OH
44143-1509
US

V. Phone/Fax

Practice location:
  • Phone: 440-542-5025
  • Fax:
Mailing address:
  • Phone: 440-867-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN339175
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.15457NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.15457
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: