Provider Demographics
NPI:1417558990
Name:WARD, MUNIRA AMIRALI
Entity type:Individual
Prefix:
First Name:MUNIRA
Middle Name:AMIRALI
Last Name:WARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 VALLEY HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3197
Mailing Address - Country:US
Mailing Address - Phone:919-961-0786
Mailing Address - Fax:984-220-9363
Practice Address - Street 1:2617 VALLEY HAVEN DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3197
Practice Address - Country:US
Practice Address - Phone:919-961-0786
Practice Address - Fax:984-220-9363
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013724363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5013724OtherNC STATE BOARD OF NURSING