Ballard, La Dena Ann

Ballard, La Dena Ann is an individual health care provider with primary practice located at 1809 E 13Th St Suite 100, Tulsa OK 74104-4419. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ballard, La Dena Ann can be contacted via phone (918) 582-6800.

Contact Information

Primary practice address
1809 E 13Th St Suite 100 Tulsa OK 74104-4419
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1467 Oklahoma

Profile Details

NPI number 1740241553
LBN Legal business name Ballard, La Dena Ann
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Aug 20th, 2013 - about 12 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 1740241553 NPPES
Oklahoma MEDICAID 200063150A

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