Provider Demographics
NPI:1578604088
Name:WARD, LAWRENCE ALFRED (LVN)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ALFRED
Last Name:WARD
Suffix:
Gender:M
Credentials:LVN
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:530-872-3185
Practice Address - Street 1:5 HILDA WAY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1417
Practice Address - Country:US
Practice Address - Phone:530-899-3759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN189157164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse