Provider Demographics
NPI:1134353956
Name:WARD, KINSEY NICOLE (CDM)
Entity type:Individual
Prefix:MRS
First Name:KINSEY
Middle Name:NICOLE
Last Name:WARD
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 876882
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6882
Mailing Address - Country:US
Mailing Address - Phone:907-357-7567
Mailing Address - Fax:
Practice Address - Street 1:3530 W RIVERDELL DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8758
Practice Address - Country:US
Practice Address - Phone:907-357-7567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK58176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife