Individual
CASSALA WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-C
Contact information
Practice address
401 S CHURCH ST, CHARLESTON, MS 38921-2257
(662) 647-5816
Mailing address
PO BOX 27, CHARLESTON, MS 38921-0027
(662) 647-5816
(662) 647-5705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R858468
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06382561
—
MS
Enumeration date
08/27/2015
Last updated
05/02/2017
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