Individual
SHANNA BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
80 SHARRON AVE, PLATTSBURGH, NY 12901-4700
(518) 561-1447
(518) 562-8812
Mailing address
PO BOX 417153, BOSTON, MA 02241-7153
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
595969
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008257
—
NY
Enumeration date
04/24/2014
Last updated
04/24/2014
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