Provider Demographics
NPI:1477223576
Name:WARD, KATHERINE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8881 FLETCHER PARKWAY
Mailing Address - Street 2:ST. 200
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-5705
Mailing Address - Country:US
Mailing Address - Phone:619-464-6434
Mailing Address - Fax:760-827-7225
Practice Address - Street 1:8881 FLETCHER PARKWAY
Practice Address - Street 2:ST. 200
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-5705
Practice Address - Country:US
Practice Address - Phone:619-464-6434
Practice Address - Fax:760-827-7225
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95017921363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95112294OtherCALIFORNIA BOARD OF REGISTERED NURSING
CANP95017921OtherCALIFORNIA BOARD OF REGISTERED NURSING