Darrell Ballard
Community Health Worker in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1194118455
StatusActive
Last updated in NPPESMar 11, 2015
Details
- NPI
- 1194118455
- Entity type
- Individual (NPI-1)
- Name
- Darrell Ballard
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 11, 2015
- Last updated
- Mar 11, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
4104 Herblinda LnNorth Las Vegas, NV 89032-2707
Phone 702-351-1416
Mailing address
4104 Herblinda LnNorth Las Vegas, NV 89032-2707
Phone 702-351-1416
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