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NPI Code Detail

MEDICARE: LORI BALLARD RN

MEDICARE:   LORI  BALLARD  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
1163W00000XRegistered NurseRN.360194OH

General Provider Information

NPI Number : 1881280022
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI BALLARD RN
Provider Business Mailing Address
First Line : 108 E PARKWOOD DR
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-3742
Country : US
Telephone Number : 937-405-5756
Fax Number :
Provider Business Practice Location Address
First Line : 4977 NORTHCUTT PL
Second Line :
City : DAYTON
State : OH
Zip : 45414-3839
Country : US
Telephone Number : 800-829-5461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2020
Last Update Date : 02/02/2026

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