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General NPI Number Information
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NPI Number | 1578073276
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Entity Type | Organization
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Legal Business Name | LISA S. BALL, FAMILY HEALTH NP, PLLC
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Dates
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Enumeration Date | 10/07/2017
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Last Update Date | 10/07/2017
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Provider Practice Location Address
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Address Line | 1140 YOUNGS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-8054
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Country | US
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Telephone | 716-688-0020
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Fax | 716-688-2328
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Provider Business Mailing Address
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Address Line | 146 SAGEWOOD TER
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4718
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Country | US
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Telephone | 716-982-4165
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA SHERRY BALL
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Credential | FNP
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Telephone | 716-982-4165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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