Individual
JONATHAN D BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
835 W EMMITT AVE, WAVERLY, OH 45690-1190
(740) 947-7662
(740) 941-0099
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.025703
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0372064
—
OH
01
—
417733
NURSING LICENSE
OH
Enumeration date
02/11/2019
Last updated
11/27/2024
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