Individual
KASEY L WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
164 S 5TH ST, MONTPELIER, ID 83254-1597
(208) 847-1630
Mailing address
164 S 5TH ST, MONTPELIER, ID 83254-1597
(208) 847-1630
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
13835971-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
72880
ID
Other
Enumeration date
08/10/2022
Last updated
04/10/2026
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