Healthcare Provider Details

I. General information

NPI: 1295474633
Provider Name (Legal Business Name): LANCE LORRAINE BALLARD-CASH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 MOORE HAVEN DR E
CLEARWATER FL
33763-1613
US

IV. Provider business mailing address

2000 CLIFFMINE RD STE 500
PITTSBURGH PA
15275-1053
US

V. Phone/Fax

Practice location:
  • Phone: 765-635-8052
  • Fax:
Mailing address:
  • Phone: 727-210-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9410355
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN9410355
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11020495
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11020495
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: