Provider Demographics
NPI:1407997422
Name:WARD, ELLAMAY BLAKEMORE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELLAMAY
Middle Name:BLAKEMORE
Last Name:WARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 WAGGONER RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-2523
Mailing Address - Country:US
Mailing Address - Phone:530-872-3185
Mailing Address - Fax:
Practice Address - Street 1:1462 FILBERT AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2907
Practice Address - Country:US
Practice Address - Phone:530-345-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524736163WC0400X, 163WM0705X, 163WP0200X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice