Provider Demographics
NPI:1851768030
Name:WARD, MILISSA
Entity Type:Individual
Prefix:
First Name:MILISSA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MILISSA
Other - Middle Name:
Other - Last Name:CHAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1642 S PRIEST DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6204
Mailing Address - Country:US
Mailing Address - Phone:480-929-5100
Mailing Address - Fax:480-731-1066
Practice Address - Street 1:1642 S PRIEST DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6204
Practice Address - Country:US
Practice Address - Phone:480-929-5100
Practice Address - Fax:480-731-1066
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN103383163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health