MEDICARE: MORGAN JOLYNN BALL

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	363LA2200X	Adult Health Nurse Practitioner	28463	SC

General Provider Information

NPI Number	:	1598511917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN JOLYNN BALL

Provider Business Mailing Address
First Line	:	9714 FANNING BASKET LN
Second Line	:
City	:	LADSON
State	:	SC
Zip	:	29456-4451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	885 ISLAND PARK DR STE B
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-8392
Country	:	US
Telephone Number	:	843-900-6161
Fax Number	:

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

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	04/26/2024

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