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Individual

MS. CHRISTEN BALLOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N

Contact information

Practice address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 823-0739
(516) 823-1550
Mailing address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 823-0739
(516) 823-1550

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
686053
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
686053
R.N LICENSE NUMBER
NY
Enumeration date
09/08/2014
Last updated
09/08/2014
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