Provider Demographics
NPI:1568970093
Name:WARD-LOPEZ, ASHLEY ANDREA (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANDREA
Last Name:WARD-LOPEZ
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 1:1276 BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-8178
Mailing Address - Country:US
Mailing Address - Phone:912-398-8001
Mailing Address - Fax:
Practice Address - Street 1:420 MALL BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4888
Practice Address - Country:US
Practice Address - Phone:912-644-5815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241150163WC1500X, 163WH0200X, 163WM0102X, 163WM0705X, 163WP1700X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP1700XNursing Service ProvidersRegistered NursePerinatal