Individual
ROSA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
Mailing address
2001 COWLES ST APT 6, FAIRBANKS, AK 99701-5938
(907) 374-7702
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6342
AK
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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