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1275836991
SHANNON L BALLARD
TUPELO, MS
NPI
1275836991
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Former Name
SHANNON MOBLEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MS R870654)
Enumeration Date
2010-12-20
Last Update Date
2011-02-21
Business Address
-- SHANNON L BALLARD NP
830 S GLOSTER ST
TUPELO, MS 38801-4934
Phone number: 800-893-9698
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Mailing Address
-- SHANNON L BALLARD NP
200 CORPORATE BLVD SUITE 201
LAFAYETTE, LA 70508-3870
Phone number: 800-893-9698
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