Provider Demographics
NPI:1992170286
Name:WARD, JOAN (LPN)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 N 68TH ST
Mailing Address - Street 2:5536 N.68TH ST.
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2905
Mailing Address - Country:US
Mailing Address - Phone:414-377-1326
Mailing Address - Fax:
Practice Address - Street 1:5536 N 68TH ST
Practice Address - Street 2:5536 N.68TH ST.
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2905
Practice Address - Country:US
Practice Address - Phone:414-377-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI307952-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse