MEDICARE: KRISTA WARD LPN

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
1	164W00000X	Licensed Practical Nurse	162155	OH

General Provider Information

NPI Number	:	1285181370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA WARD LPN

Provider Business Mailing Address
First Line	:	1931 E 4TH ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1909
Country	:	US
Telephone Number	:	419-618-4260
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 E 4TH ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1909
Country	:	US
Telephone Number	:	419-618-4260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2016
Last Update Date	:	09/06/2016

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Directions to “ KRISTA WARD LPN” Practice Location

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