Provider Demographics
NPI:1851604508
Name:WARD, CAROLYN MICHELLE (CNM)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:WARD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:MICHELLE
Other - Last Name:PIKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:1204 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-1602
Practice Address - Country:US
Practice Address - Phone:434-924-2500
Practice Address - Fax:434-244-9487
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife