Judi Laura Ball, LPN

Key facts

NPI

1154952208

Entity type

Individual (NPI type 1)

Primary specialty

Licensed Practical Nurse 164W00000X

License

LP00040279 (WA)

Practice address

1210 SW 136TH St
Burien, WA 98166-1214

Phone

(206) 241-0990

NPI assigned

Jan 28, 2020

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 28, 2020.

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1154952208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 N 29TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984075307",
            "telephone_number": "808-494-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SW 136TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661214",
            "telephone_number": "206-241-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "JUDI",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00040279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Burien, WA · Licensed Practical Nurse in Washington