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1144086109
MIRANDA DIANNE BALLARD
THOUSAND OAKS, CA
NPI
1144086109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95029217)
Enumeration Date
2024-02-26
Last Update Date
2024-02-26
Business Address
MIRANDA DIANNE BALLARD FNP-BC
215 W JANSS RD
THOUSAND OAKS, CA 91360-1847
Phone number: 805-370-4435
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Mailing Address
MIRANDA DIANNE BALLARD FNP-BC
2116 VANGUARD DR
CAMARILLO, CA 93010-2132
Phone number: 805-233-0242
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