Healthcare Provider Details

I. General information

NPI: 1346193117
Provider Name (Legal Business Name): EMILY PATTERSON-BALLINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 MISSISSIPPI PKWY STE B200
CROWN POINT IN
46307-6902
US

IV. Provider business mailing address

PO BOX 781076
DETROIT MI
48278-1008
US

V. Phone/Fax

Practice location:
  • Phone: 219-757-5890
  • Fax: 219-757-5740
Mailing address:
  • Phone: 317-528-4800
  • Fax: 317-865-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number71017932A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number28215893A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: