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Individual
STEPHANIE BALLY
Active
Individual
STEPHANIE BALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5378990072
KS
363LF0000X
Family Nurse Practitioner
Primary
78990
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201267470A
—
KS
Enumeration date
09/17/2019
Last updated
03/21/2024
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