Amanda Faye Ballard

Individual provider Active NPI Surgical Technologist · Gallup, NM

NPI 1013593607 · NPPES record last updated Mar 23, 2021

Key facts

NPI
1013593607
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Technologist 246ZS0410X
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X Yes

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

1004 8TH St
Las Vegas, NM 87701-4216

Other providers in Gallup, NM

All providers in Gallup, NM · Surgical Technologist in New Mexico

Sources for this page

Verify at the official NPI Registry.