Nancy A Ballard, LPN

Individual provider Active NPI Licensed Practical Nurse · Arcadia, FL

NPI 1083940449 · NPPES record last updated Jul 18, 2016

Key facts

NPI
1083940449
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN5180101 (FL)
Practice address
34 S Baldwin Ave
Arcadia, FL 34266-3387
Phone
(863) 491-7580
Fax
(863) 491-7584
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN5180101FLMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5180101 FL Yes

Addresses

Primary practice location

34 S Baldwin Ave
Arcadia, FL 34266-3387

Mailing address

34 S Baldwin Ave
Arcadia, FL 34266-3387
Phone (863) 491-7580

Other identifiers

IdentifierTypeStateIssuer
PN5180101OtherFLLPN LICENSE

Other providers in Arcadia, FL

All providers in Arcadia, FL · Licensed Practical Nurse in Florida

Sources for this page

Verify at the official NPI Registry.