Healthcare Provider Details

I. General information

NPI: 1457878985
Provider Name (Legal Business Name): JULIA ROSE BALL DMSC MPAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 COFFMAN STREET
LONGMONT CO
80503-5918
US

IV. Provider business mailing address

201 COFFMAN ST
LONGMONT CO
80501-5918
US

V. Phone/Fax

Practice location:
  • Phone: 720-575-6614
  • Fax: 720-780-7057
Mailing address:
  • Phone: 720-575-6614
  • Fax: 720-780-7057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9110651
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: