Individual
LAUREL L. BALLENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103
(856) 342-2351
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NJ00057400
NJ
363LF0000X
Family Nurse Practitioner
NJ00057400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050253
—
NJ
Enumeration date
06/08/2006
Last updated
08/23/2024
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