Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 58 | AK |
NPI | 1134353956 |
---|---|
Provider Name | Mrs. Kinsey Nicole Ward |
First Address | Wasilla, AK 99687-6882 |
Second Address | Wasilla, AK 99654-8758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2009 |
Last Update Date | 07/05/2009 |