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NPI Code Detail

MEDICARE: JASMINE JANAY BALLARD

MEDICARE:   JASMINE JANAY BALLARD
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1174226799
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE JANAY BALLARD
Provider Business Mailing Address
First Line : 223 WATERSIDE DR
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-2222
Country : US
Telephone Number : 551-206-8200
Fax Number :
Provider Business Practice Location Address
First Line : 223 WATERSIDE DR
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-2222
Country : US
Telephone Number : 551-206-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 11/19/2024

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Directions to “ JASMINE JANAY BALLARD ” Practice Location

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