Individual
SHANNON WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2395 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5876
(928) 505-6022
Mailing address
2395 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5876
(928) 505-6022
(928) 505-6039
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP051405
AZ
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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