Individual
DARRELL BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4104 HERBLINDA LN, NORTH LAS VEGAS, NV 89032-2707
(702) 351-1416
Mailing address
4104 HERBLINDA LN, NORTH LAS VEGAS, NV 89032-2707
(702) 351-1416
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172V00000X
—
NV
Enumeration date
03/11/2015
Last updated
03/11/2015
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