Individual
MRS. STEPHANIE A BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
19 TYLER ST STE 301, NASHUA, NH 03060-2951
(603) 595-0063
(603) 595-9419
Mailing address
PO BOX 3677, NASHUA, NH 03061-3677
(603) 577-7900
(603) 577-7972
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
032138-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RE2724
MEDICARE GROUP PTAN
NH
Enumeration date
12/31/2009
Last updated
08/31/2020
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