Individual
JACOB JAMES BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
302 HOBART ST, CADILLAC, MI 49601-2379
(231) 876-2644
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 392-0421
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704293945
MI
Other
Enumeration date
02/06/2020
Last updated
03/04/2020
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