Individual
REATHA W. BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
35 MILES ST, DAMARISCOTTA, ME 04543-4047
(207) 563-4904
Mailing address
1414 GOLDEN SPRINGSROAD, #305, ANNISTON, AL 36207
(256) 239-0569
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-025847
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933232
—
AL
Enumeration date
04/28/2006
Last updated
08/26/2020
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