Provider Demographics
NPI:1699816728
Name:WARD, KIMBERLY MARIE (RN)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:MARIE
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 1:935 WAGGONER RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-2523
Mailing Address - Country:US
Mailing Address - Phone:530-872-3185
Mailing Address - Fax:
Practice Address - Street 1:9520 PERKINS RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8907
Practice Address - Country:US
Practice Address - Phone:530-898-8104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526744163WG0000X, 163WM0705X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics