Individual
JAMES L BALLENTINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7822 DAVENPORT STREET, OMAHA, NE 68114-3629
(402) 391-4855
(402) 391-6818
Mailing address
7822 DAVENPORT STREET, OMAHA, NE 68114-3629
(402) 391-4855
(402) 391-6818
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100951
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280299
MEDICARE
—
01
—
P00321370
RR MEDICARE
—
Enumeration date
07/17/2006
Last updated
05/26/2016
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