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Traci Lynn Ballard, PA

Physician Assistant in Concord, NC. Individual provider (NPI-1).

NPI number1144338740
StatusActive
Last updated in NPPESAug 28, 2024

Details

NPI
1144338740
Entity type
Individual (NPI-1)
Name
Traci Lynn Ballard
Credential
PA
Sex
Female
Sole proprietor
No
Enumeration date
Aug 25, 2006
Certification date
Aug 28, 2024
Last updated
Aug 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant0010-00926NCYes
363AS0400X Physician Assistant, Surgical0010-00926NC

Practice location

200 Medical Park Dr
Ste 430
Concord, NC 28025-2982

Phone 704-403-7070

Mailing address

Po Box 19305
Charlotte, NC 28219-9305

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