Provider Demographics
NPI:1073807020
Name:WARD, ANGELA D (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:WARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TN
Mailing Address - Zip Code:37322-0157
Mailing Address - Country:US
Mailing Address - Phone:423-334-5185
Mailing Address - Fax:
Practice Address - Street 1:400 RIVER RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TN
Practice Address - Zip Code:37322-7857
Practice Address - Country:US
Practice Address - Phone:423-334-5185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN145624163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse