| NPI | 1437502739 |
|---|---|
| Former Name | LISA WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016028514) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77700-041) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2023-07-26 |