Provider Demographics
NPI:1619303526
Name:WARD, MONICA NICOLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:NICOLE
Last Name:WARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 PAMONA DR 104E
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-9127
Mailing Address - Country:US
Mailing Address - Phone:440-855-4289
Mailing Address - Fax:
Practice Address - Street 1:1738 PAMONA DR APT 104E
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-9127
Practice Address - Country:US
Practice Address - Phone:440-855-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153906-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse