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General NPI Number Information
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NPI Number | 1114892171
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Entity Type | Individual
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Provider Name | JOHNNA MCKENZIE BALL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 4610 KANAWHA AVE SW
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-1367
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Country | US
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Telephone | 304-741-8638
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Fax | 304-720-8702
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Provider Business Mailing Address
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Address Line | 4610 KANAWHA AVE SW
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-1367
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Country | US
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Telephone | 304-741-8638
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Fax | 304-720-8702
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0014412
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License Number State | WV
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