| NPI | 1013595420 |
|---|---|
| Former Name | JERRICA BALLANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AR 214728) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2022-04-26 |