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General NPI Number Information
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NPI Number | 1255360319
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Entity Type | Organization
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Legal Business Name | CAROLE WARD, FNP-C PC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 1645 N 18TH ST
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City | MEMPHIS
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State | TX
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Zip | 79245-2059
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Country | US
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Telephone | 806-259-1058
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Fax | 806-259-1060
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Provider Business Mailing Address
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Address Line | 1645 N 18TH ST
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City | MEMPHIS
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State | TX
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Zip | 79245-2059
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Country | US
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Telephone | 806-259-1058
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Fax | 806-259-1060
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Authorized Official
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Title or Position | NURSE PRACTITIONER OWNER
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Name | CAROLE WARD
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Credential | RN,FNPC
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Telephone | 806-259-1058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 231272
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License Number State | TX
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