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Individual

MS. VICKI D WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS FNP PSYCH NP

Contact information

Practice address
1108 W US ROUTE 66, MORIARTY, NM 87035-1006
(505) 832-4434
(505) 832-5024
Mailing address
12127 HWY 14 N STE 5B, CEDAR CREST, NM 87008-9461
(508) 776-6153

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02142
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0799963
MA
Enumeration date
09/17/2006
Last updated
07/18/2013
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