Provider Demographics
NPI:1952110447
Name:WARD, ANDRE JOSEPH (FNP)
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:JOSEPH
Last Name:WARD
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LIGHTHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-4468
Mailing Address - Country:US
Mailing Address - Phone:903-340-7221
Mailing Address - Fax:
Practice Address - Street 1:305 BONITA ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-5743
Practice Address - Country:US
Practice Address - Phone:903-340-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1183772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily