Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 1017610 | TX |
NPI | 1063092195 |
---|---|
Provider Name | Sherressa Lynn Ward |
First Address | Houston, TX 77045-3607 |
Second Address | Houston, TX 77003-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2021 |
Last Update Date | 22/12/2021 |