Individual
MISS KELLY JASMINE WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
4600 BROADWAY, SUITE 1100, SACRAMENTO, CA 95820-1527
(916) 874-9670
Mailing address
4600 BROADWAY, SUITE 1100, SACRAMENTO, CA 95820-1527
(916) 874-9670
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95029088
CA
163WC1500X
Community Health Registered Nurse
Primary
544319
CA
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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