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Individual
JESSE BALLARD
Active
Individual
JESSE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11985380-4405
UT
363L00000X
Nurse Practitioner
2161573
ID
363L00000X
Nurse Practitioner
AP61095878
WA
363LF0000X
Family Nurse Practitioner
11985380-4405
UT
Other
Enumeration date
10/02/2020
Last updated
04/15/2026
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