Healthcare Provider Details

I. General information

NPI: 1235049560
Provider Name (Legal Business Name): HALEY NICOLE BALL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36475 FIVE MILE RD
LIVONIA MI
48154-1971
US

IV. Provider business mailing address

4639 PINEWAY DR
FENTON MI
48430-9207
US

V. Phone/Fax

Practice location:
  • Phone: 734-655-4800
  • Fax:
Mailing address:
  • Phone: 248-515-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: