| NPI | 1003012352 |
|---|---|
| Former Name | CARRIE JEAN BALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002416A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71002416A) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2024-12-13 |