MEDICARE: JUANITA BALL RN

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	163W00000X	Registered Nurse	RNZ8899	NV

General Provider Information

NPI Number	:	1164582979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUANITA BALL RN

Provider Business Mailing Address
First Line	:	4126 TECHNOLOGY WAY
Second Line	:	SUITE 102
City	:	CARSON CITY
State	:	NV
Zip	:	89706-2009
Country	:	US
Telephone Number	:	775-687-7573
Fax Number	:	775-687-7544

Provider Business Practice Location Address
First Line	:	3595 HWY 50 WEST
Second Line	:
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429
Country	:	US
Telephone Number	:	775-577-0319
Fax Number	:	775-577-9571

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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