Ballard, Amy M.

Ballard, Amy M. is an individual health care provider with primary practice located at 830 S Gloster St Nmmc East Tower Third Floor, Tupelo MS 38801-4934. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Ballard, Amy M. can be contacted via phone (662) 377-7170.

Contact Information

Primary practice address
830 S Gloster St Nmmc East Tower Third Floor Tupelo MS 38801-4934
Phone: (662) 377-7170
Fax: (662) 377-7180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA027 Mississippi

Profile Details

NPI number 1528153558
LBN Legal business name Ballard, Amy M.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528153558 NPPES
Mississippi MEDICAID 00126597

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