Healthcare Provider Details

I. General information

NPI: 1598511917
Provider Name (Legal Business Name): MORGAN JOLYNN BALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 ISLAND PARK DR STE B
DANIEL ISLAND SC
29492-8392
US

IV. Provider business mailing address

9714 FANNING BASKET LN
LADSON SC
29456-4451
US

V. Phone/Fax

Practice location:
  • Phone: 843-900-6161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28463
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: