Healthcare Provider Details

I. General information

NPI: 1285557082
Provider Name (Legal Business Name): NICOLE WARD BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11964 ARMSTRONG RD
SODDY DAISY TN
37379-5915
US

IV. Provider business mailing address

11964 ARMSTRONG RD
SODDY DAISY TN
37379-5915
US

V. Phone/Fax

Practice location:
  • Phone: 440-724-1057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number253900
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: