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General NPI Number Information
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NPI Number | 1720873698
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Entity Type | Individual
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Provider Name | JARED M WARD PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 4202 PRINCETON ST
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City | LUBBOCK
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State | TX
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Zip | 79415-1308
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Country | US
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Telephone | 806-515-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 JASON AVE
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City | LUBBOCK
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State | TX
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Zip | 79407-3006
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Country | US
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Telephone | 949-246-9195
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1037607
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License Number State | TX
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