Individual
DR. MICHELE MARIE BALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP APRN CRNA CHSE
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 822-1411
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
289363
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
3758
SC
Other
Enumeration date
01/22/2009
Last updated
04/29/2024
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