Individual
LA DENA ANN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2431 E 61ST ST STE 500, TULSA, OK 74136-1208
(918) 582-6800
(918) 582-6060
Mailing address
2431 E 61ST ST STE 500, TULSA, OK 74136-1208
(918) 582-6800
(918) 582-6060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1467
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200063150A
—
OK
Enumeration date
03/31/2006
Last updated
11/12/2024
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