Ballou, Amy

Ballou, Amy is an sole proprietor health care provider with primary practice located at 14041 Icot Blvd , Clearwater FL 33760-3702. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ballou, Amy can be contacted via phone (727) 479-1897.

Contact Information

Primary practice address
14041 Icot Blvd Clearwater FL 33760-3702
Phone: (727) 479-1897
Fax: (727) 479-1248
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP9259008 Florida

Profile Details

NPI number 1477563419
LBN Legal business name Ballou, Amy
Credentials RN, NP, BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2006
Last updated May 13th, 2013 - about 11 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 1477563419 NPPES
Florida MEDICAID 768606400

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