Provider Demographics
NPI:1730448838
Name:WARD, DENNIS AUSTIN (RN)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:AUSTIN
Last Name:WARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N HUNT AVE
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-8618
Mailing Address - Country:US
Mailing Address - Phone:580-331-3300
Mailing Address - Fax:580-331-3565
Practice Address - Street 1:RR 1 BOX 3060
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-9303
Practice Address - Country:US
Practice Address - Phone:580-331-3300
Practice Address - Fax:580-331-3565
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR 85890163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKR 85890OtherLICENSE