| NPI | 1558685156 |
|---|---|
| Former Name | JOHANNA SHEA BALLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209027598) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209027598) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2023-06-23 |