Provider Demographics
NPI:1790564334
Name:WARD, TAYLA MARIE (CPM)
Entity Type:Individual
Prefix:
First Name:TAYLA
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:TAYLA
Other - Middle Name:MARIE WARD
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPM
Mailing Address - Street 1:410 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:BLOSSOM
Mailing Address - State:TX
Mailing Address - Zip Code:75416-2743
Mailing Address - Country:US
Mailing Address - Phone:940-535-4989
Mailing Address - Fax:
Practice Address - Street 1:410 SUNSET ST
Practice Address - Street 2:
Practice Address - City:BLOSSOM
Practice Address - State:TX
Practice Address - Zip Code:75416-2743
Practice Address - Country:US
Practice Address - Phone:940-535-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPM23060245176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife