Doctor Name: | MRS. REBECCA PERRY WARD |
NPI Number: | 1003969304 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R686093 |
Business Practice Address: | 4381 South Eason Blvd Longtown Medical Park Tupelo, MS - 38801 |
Business Phone Number: | 6623777354 |
Business Fax Number: | 6623775301 |
Mailing Address: | 214 Dogwood Est, BOONEVILLE |
State: | MS |
Postal Code: | 388298273 |
Phone Number: | 6627281154 |
Fax Number: | 6627281154 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R686093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |