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Individual

HOLLIS LEE WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1071723
AL
363LF0000X
Family Nurse Practitioner
R881863
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011846
MAIN GROUP MEDICARE PAYEE NUMBER
AL
05
051541858
AL
01
1063439065
NPI GROUP PAYEE NUMBER
AL
01
515-41858
BLUE CROSS OF AL
AL
05
630000013
AL
Enumeration date
07/19/2006
Last updated
05/23/2014
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