Provider Demographics
NPI:1356600837
Name:WARD, ANDREA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 W CONCORDIA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-3350
Mailing Address - Country:US
Mailing Address - Phone:414-388-8293
Mailing Address - Fax:
Practice Address - Street 1:4620 W CONCORDIA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3350
Practice Address - Country:US
Practice Address - Phone:414-388-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1121494-30163WC1500X, 163WC1600X, 163WC3500X, 163WD0400X, 163WH0200X, 163WL0100X, 163WN1003X, 163WP0808X, 163W00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WN1003XNursing Service ProvidersRegistered NurseNutrition SupportGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator