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General NPI Number Information
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NPI Number | 1629686647
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Entity Type | Individual
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Provider Name | TANNICA BALL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 101 N LYNNHAVEN RD STE 302
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7523
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Country | US
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Telephone | 757-486-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 4209 QUAILSHIRE CT
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3195
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Country | US
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Telephone | 540-623-4635
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024180886
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1223924
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License Number State | VA
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