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1225616857
KRYSTA BALLARD
ROLAND, OK
NPI
1225616857
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OK l0054032)
Enumeration Date
2021-04-02
Last Update Date
2021-04-02
Business Address
KRYSTA BALLARD
117 E RAY FINE BLVD
ROLAND, OK 74954-5198
Phone number: 918-427-3344
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Mailing Address
KRYSTA BALLARD
479389 E 1060 RD.
MULDROW, OK 74948
Phone number: 479-739-5478
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