Individual
AMBER NICOLE BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
22 BOZARD ST, MANNING, SC 29102-2935
(803) 435-8828
(803) 435-2239
Mailing address
22 BOZARD ST, MANNING, SC 29102-2935
(803) 435-8828
(803) 435-2239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18710
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3502
—
SC
Enumeration date
03/24/2014
Last updated
01/16/2020
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