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MR. STEVEN R BALLARD ANP

Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1043454564

Individual Registrant:
MR. STEVEN R BALLARD ANP
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1050 W 10TH ST STE 500 ROLLA, MO 65401-2905 US
Tel: 573-308-1301  Fax: 573-308-1305

Contact information for business:
1050 W 10TH ST ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS ROLLA, MO 65401-2905 US
Tel: 573-364-9000  Fax: 573-426-2282

Registration Information:
NPI: 1043454564
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
MO105523

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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