Healthcare Provider Details

I. General information

NPI: 1134052269
Provider Name (Legal Business Name): CRYSTAL BALLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRYSTAL NAGAR

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10011 SADDLEHORN LN
HIGHLANDS RANCH CO
80130-3822
US

IV. Provider business mailing address

10011 SADDLEHORN LN
HIGHLANDS RANCH CO
80130-3822
US

V. Phone/Fax

Practice location:
  • Phone: 469-964-3200
  • Fax: 469-964-3200
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: