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MR. JIMMY E. BALLARD APRN

Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1376843458

Individual Registrant:
MR. JIMMY E. BALLARD APRN
Gender: M
Not Sole Proprietor

Location and contact information for practice:
616W KEISER AVE  OSCEOLA, AR 72370 US
Tel: 870-563-5888  Fax: 870-563-6175

Contact information for business:
PO BOX 1960  JONESBORO, AR 72403-1960 US
Tel: 870-563-5888  Fax: 870-934-3651

Registration Information:
NPI: 1376843458
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Acute Care
ARA002954

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICARE5V901AR01
188054758AR05




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