Provider Demographics
NPI:1346217395
Name:WARD, ALBERT F (ARNP)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:F
Last Name:WARD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FREDERICA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6981
Mailing Address - Country:US
Mailing Address - Phone:270-684-0023
Mailing Address - Fax:270-684-0065
Practice Address - Street 1:3600 FREDERICA ST
Practice Address - Street 2:SUITE A & B
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301
Practice Address - Country:US
Practice Address - Phone:270-684-0023
Practice Address - Fax:270-684-0065
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003462363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP30575Medicare UPIN
KY0679803Medicare ID - Type Unspecified
KY7800188Medicaid