Provider Demographics
NPI:1922138775
Name:WARD, JAYMIE D (APN)
Entity Type:Individual
Prefix:
First Name:JAYMIE
Middle Name:D
Last Name:WARD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5857 S ROBB ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1940
Mailing Address - Country:US
Mailing Address - Phone:303-904-0606
Mailing Address - Fax:
Practice Address - Street 1:10168 PARKGLENN WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3868
Practice Address - Country:US
Practice Address - Phone:303-743-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO164314163W00000X
COAPN.0991399-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO016902OtherKAISER COMMERCIAL NUMBER
CO06706771Medicaid
CO1922138775Medicare PIN
CO016902OtherKAISER COMMERCIAL NUMBER