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NPI Code Detail

MEDICARE: TERESA WARD FNP

MEDICARE: TERESA WARD FNP
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
1363LF0000XFamily Nurse Practitioner2016036884MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407308554
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA WARD FNP
Provider Business Mailing Address
First Line : PO BOX 4046
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65808-4046
Country : US
Telephone Number : 417-269-5712
Fax Number : 417-269-4869
Provider Business Practice Location Address
First Line : 816 E MAIN ST
Second Line :
City : WILLOW SPRINGS
State : MO
Zip : 65793-1518
Country : US
Telephone Number : 417-469-3116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2016
Last Update Date : 07/21/2022

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