Ryan James Ballard, CRNA
Nurse Anesthetist, Certified Registered in Rolla, MO. Individual provider (NPI-1).
NPI number1780247320
StatusActive
Last updated in NPPESApr 18, 2019
Details
- NPI
- 1780247320
- Entity type
- Individual (NPI-1)
- Name
- Mr. Ryan James Ballard
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2019
- Last updated
- Apr 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2019011200 | MO | Yes |
Practice location
1000 W 10th StRolla, MO 65401-2905
Phone 573-364-9000
Mailing address
11528 Pine Forest DrRolla, MO 65401-5427
Phone 509-855-2116
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