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NPI Code Detail

MEDICARE: JENNIFER WARD R.N.

MEDICARE: JENNIFER WARD R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN-164458CO

General Provider Information

NPI Number : 1205199718
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WARD R.N.
Provider Business Mailing Address
First Line : 1201 LONGWOOD AVE
Second Line :
City : PUEBLO
State : CO
Zip : 81004-1042
Country : US
Telephone Number : 719-583-4431
Fax Number :
Provider Business Practice Location Address
First Line : 101 W 9TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-4103
Country : US
Telephone Number : 719-583-4431
Fax Number : 719-583-4439
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2012
Last Update Date : 06/19/2012

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Directions to “ JENNIFER WARD R.N.” Practice Location

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