Individual
BILLIE DEE BAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 360-0895
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5790-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1187817
NCCPA
—
Enumeration date
05/11/2022
Last updated
05/12/2022
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