Provider Demographics
NPI:1750424099
Name:WARD, CAROL ANNE (RN, BS, DC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANNE
Last Name:WARD
Suffix:
Gender:F
Credentials:RN, BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 TIMBER RIDGE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8151
Mailing Address - Country:US
Mailing Address - Phone:502-228-7890
Mailing Address - Fax:502-228-7883
Practice Address - Street 1:5920 TIMBER RIDGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8151
Practice Address - Country:US
Practice Address - Phone:502-228-7890
Practice Address - Fax:502-228-7883
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000226303OtherANTHEM BLUE CROSS BLUE SH
KY000000226303OtherANTHEM BLUE CROSS BLUE SH