Provider Demographics
NPI:1487171484
Name:WARD, CECILIA ALCANTARA (LPN)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:ALCANTARA
Last Name:WARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6381 NORDIX DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4430
Mailing Address - Country:US
Mailing Address - Phone:703-963-1394
Mailing Address - Fax:540-935-2447
Practice Address - Street 1:6381 NORDIX DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-4430
Practice Address - Country:US
Practice Address - Phone:703-963-1394
Practice Address - Fax:540-935-2447
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002093270164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse