Individual
NINA MILLS BALLANTYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1017 DAMASCUS CIR, COSTA MESA, CA 92626-1608
(413) 687-9263
(714) 707-4119
Mailing address
1017 DAMASCUS CIR, COSTA MESA, CA 92626-1608
(413) 687-9263
(714) 707-4119
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
95010744
CA
367A00000X
Advanced Practice Midwife
Primary
235994
CA
367A00000X
Advanced Practice Midwife
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467590901
—
CA
Enumeration date
11/09/2018
Last updated
03/23/2024
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