Healthcare Provider Details

I. General information

NPI: 1265539738
Provider Name (Legal Business Name): VALERIE LYNN BALL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 1ST ST SE
BELMOND IA
50421-1201
US

IV. Provider business mailing address

403 1ST ST SE
BELMOND IA
50421-1201
US

V. Phone/Fax

Practice location:
  • Phone: 641-444-3500
  • Fax: 515-532-9336
Mailing address:
  • Phone: 641-444-3500
  • Fax: 515-532-9336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number63502
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD068816
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: