MEDICARE: COURTNEY KRYSTYNA BALL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	34337	TN

General Provider Information

NPI Number	:	1134618580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY KRYSTYNA BALL PHARMD

Provider Business Mailing Address
First Line	:	8435 WALBROOK DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3115
Country	:	US
Telephone Number	:	865-694-3257
Fax Number	:	865-694-4132

Provider Business Practice Location Address
First Line	:	8435 WALBROOK DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3115
Country	:	US
Telephone Number	:	865-694-3257
Fax Number	:	865-694-4132

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2018
Last Update Date	:	05/01/2018

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