Provider Demographics
NPI:1740636505
Name:WARD, VICTORIA MYRTLE (PA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MYRTLE
Last Name:WARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3277 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2512
Mailing Address - Country:US
Mailing Address - Phone:720-274-0341
Mailing Address - Fax:720-274-0367
Practice Address - Street 1:3277 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2512
Practice Address - Country:US
Practice Address - Phone:720-274-0341
Practice Address - Fax:720-274-0367
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0005384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant