Provider Demographics
NPI:1104253665
Name:WARD, LINDA (CNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:6688 METRO PARK DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1509
Mailing Address - Country:US
Mailing Address - Phone:440-867-4620
Mailing Address - Fax:
Practice Address - Street 1:30680 BAINDRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139
Practice Address - Country:US
Practice Address - Phone:440-542-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN339175163W00000X
OHCOA.15457NP363L00000X
OHAPRN.CNP.15457363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0095899Medicaid