| NPI | 1942544689 |
|---|---|
| Former Name | ANGELA BALLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007586) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007586) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2016-06-13 |