Provider Demographics
NPI:1154020139
Name:WARD, EMILY ROSE (RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:WARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3819
Mailing Address - Country:US
Mailing Address - Phone:781-330-4188
Mailing Address - Fax:
Practice Address - Street 1:99 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3819
Practice Address - Country:US
Practice Address - Phone:781-330-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2333677163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse