Healthcare Provider Details

I. General information

NPI: 1780832691
Provider Name (Legal Business Name): MARCI ANN WARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCI ANN TARASE NP

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-7208
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-7700
  • Fax: 214-645-7701
Mailing address:
  • Phone: 214-645-7700
  • Fax: 214-645-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberARNP9166284
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9166284
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number844812
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: