Healthcare Provider Details

I. General information

NPI: 1063323855
Provider Name (Legal Business Name): CHELSEA CHRISTINE WARD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BOWER DR STE 230
MEDFORD OR
97501-3689
US

IV. Provider business mailing address

21105 LAKE WOOD TRL
KIRKSVILLE MO
63501-8076
US

V. Phone/Fax

Practice location:
  • Phone: 541-732-8300
  • Fax: 541-732-3411
Mailing address:
  • Phone: 970-833-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10066351
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: