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General NPI Number Information
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NPI Number | 1225646870
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Entity Type | Individual
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Provider Name | LAURA WARD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 114 BUSINESS CENTER DR
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1229
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Country | US
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Telephone | 410-833-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 123 N LONGCROSS RD
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City | LINTHICUM
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State | MD
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Zip | 21090-2328
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Country | US
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Telephone | 410-245-4971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG07200149
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License Number State | MD
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