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General NPI Number Information
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NPI Number | 1730637224
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Entity Type | Individual
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Provider Name | JESSICA BALLARD DNP, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 77 NEALY AVENUE
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City | JOINT BASE LANGLEY-EUSTIS
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State | VA
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Zip | 23665
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Country | US
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Telephone | 757-764-8290
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Fax |
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Provider Business Mailing Address
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Address Line | 77 NEALY AVENUE
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City | JOINT BASE LANGLEY-EUSTIS
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State | VA
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Zip | 23665
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Country | US
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Telephone | 757-764-8290
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | RN185372
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP8891
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License Number State | AZ
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