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General NPI Number Information
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NPI Number | 1295342913
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Entity Type | Individual
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Provider Name | EMILY COREEN BALL FNP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2020
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 1145 S MAIN ST UNIT A
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City | CHELSEA
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State | MI
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Zip | 48118-1408
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Country | US
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Telephone | 517-205-8667
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Fax |
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Provider Business Mailing Address
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Address Line | 9460 SCULLY RD
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City | WHITMORE LAKE
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State | MI
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Zip | 48189-9690
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Country | US
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Telephone | 970-379-8773
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 10941553-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704378073
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License Number State | MI
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