Provider Demographics
NPI:1821631128
Name:WARD, LEAH LINDSLEY (RN, MSN)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:LINDSLEY
Last Name:WARD
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2569 HIGHWAY 503
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MS
Mailing Address - Zip Code:39345-9286
Mailing Address - Country:US
Mailing Address - Phone:601-917-5931
Mailing Address - Fax:
Practice Address - Street 1:1314 19TH AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4116
Practice Address - Country:US
Practice Address - Phone:601-703-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-20
Last Update Date:2019-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR865858163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse