Provider Demographics
NPI:1184096125
Name:WARD, ANDREA NICOLE (APRN)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:NICOLE
Last Name:WARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15002 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4727
Mailing Address - Country:US
Mailing Address - Phone:402-739-5135
Mailing Address - Fax:
Practice Address - Street 1:144 S 39TH ST STE 2D
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3050
Practice Address - Country:US
Practice Address - Phone:402-890-8160
Practice Address - Fax:402-702-1562
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111935363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily