Individual
DR. NICOLE BALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213
(414) 454-6600
(414) 454-6766
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6600
(414) 454-6766
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
52794-021
WI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
52794-021
WI
Other
Enumeration date
10/10/2006
Last updated
11/22/2021
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