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General NPI Number Information
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NPI Number | 1497660500
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Entity Type | Organization
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Legal Business Name | JOHNSON & BALLNER LLC
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 2780 S JONES BLVD STE 221
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City | LAS VEGAS
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State | NV
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Zip | 89146-5628
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Country | US
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Telephone | 320-260-7472
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 S JONES BLVD STE 221
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City | LAS VEGAS
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State | NV
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Zip | 89146-5628
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Country | US
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Telephone | 320-260-7472
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DEREK JOHNSON
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Credential | NP, PMHNP
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Telephone | 320-260-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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