Individual provider · NPI-1

Lacey Camille Ballard, CNM

Advanced Practice Midwife · Tacoma, WA

NPI number1154064061
StatusActive
Last updated in NPPESApr 10, 2026

Details

NPI
1154064061
Entity type
Individual (NPI-1)
Name
Lacey Camille Ballard
Credential
CNM
Sex
Female
Sole proprietor
No
Enumeration date
Apr 18, 2022
Certification date
Apr 10, 2026
Last updated
Apr 10, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367A00000X Advanced Practice MidwifeAP61574353WAYes

Practice location

4215 49th Ave Ne
Tacoma, WA 98422-2421

Phone 253-459-7699 · Fax 253-942-8735

Mailing address

Po Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice locations

875 Monroe Ave
Memphis, TN 38103-4901

Phone 901-448-6128

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