Healthcare Provider Details

I. General information

NPI: 1952365066
Provider Name (Legal Business Name): JOYCE A BALL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYCE A BALL CNM

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

220 EAGLE PINES DR
WOODLAND PARK CO
80863-7429
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7358
  • Fax:
Mailing address:
  • Phone: 719-466-1738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberC-APN-0100002-C-CNM
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: