| NPI | 1437698321 |
|---|---|
| Former Name | SIDNEY LEE BALLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22225) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 22225) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174530) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2026-05-01 |