Provider Demographics
NPI:1285113399
Name:WARD, LYNN (HEALTH EDUCATOR)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 RUE BEAU CHENE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-2071
Mailing Address - Country:US
Mailing Address - Phone:769-798-1702
Mailing Address - Fax:
Practice Address - Street 1:215 RUE BEAU CHENE RD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2071
Practice Address - Country:US
Practice Address - Phone:769-798-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator