| NPI | 1700013133 |
|---|---|
| Former Name | AMANDA ROSE BALLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 18991) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 209007049) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-04-07 |