Individual
VANESSA RIVAS BALLIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA060268
PA
Other
Enumeration date
11/09/2018
Last updated
11/03/2025
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