Individual
MRS. JESSICA L BALLOULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
300 PALMETTO HEALTH PKWY STE 300, COLUMBIA, SC 29212-1763
(803) 907-7700
(803) 907-7309
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22973
SC
Other
Enumeration date
07/02/2019
Last updated
09/30/2022
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