Provider Demographics
NPI:1003315599
Name:WARD, ANDREA LYNN
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:TENNANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:NOWATA
Mailing Address - State:OK
Mailing Address - Zip Code:74048-4628
Mailing Address - Country:US
Mailing Address - Phone:918-504-6442
Mailing Address - Fax:
Practice Address - Street 1:325 S ASH ST
Practice Address - Street 2:
Practice Address - City:NOWATA
Practice Address - State:OK
Practice Address - Zip Code:74048-4628
Practice Address - Country:US
Practice Address - Phone:844-458-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator