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Individual

DR. NINA GABRIELLE BALLEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
4411 THE 25 WAY NE STE 325, ALBUQUERQUE, NM 87109-5853
(505) 888-5757
Mailing address
1720 S MICHIGAN AVE APT 917, CHICAGO, IL 60616-4892
(806) 928-5260

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011441
IL

Other

Enumeration date
06/15/2020
Last updated
06/30/2020
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