Individual
MR. JEFFREY BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN,FNP-BC
Contact information
Practice address
844 S MADISON ST, TUPELO, MS 38801-4904
(662) 377-5400
Mailing address
1150 S GREEN ST, SUITE 1A, TUPELO, MS 38804-4901
(662) 377-5050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R874051
MS
Other
Enumeration date
01/30/2014
Last updated
03/24/2015
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