Provider Demographics
NPI:1356326946
Name:WARD, PAMELA J (CNM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:WARD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 EAST AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5299
Mailing Address - Country:US
Mailing Address - Phone:401-727-4800
Mailing Address - Fax:401-728-4437
Practice Address - Street 1:407 EAST AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5299
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-728-4437
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICMW00128367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0367991Medicaid
RIMW00128OtherLICENSE
MA0367991Medicaid