Marty Kyle Ballard, FNP Valid NPI

Individual provider · Family Nurse Practitioner · Brookhaven, MS

NPI

1023622081

Type

Individual (Type 1)

Primary specialty

Family Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LF0000X

License number

904046 (MS)

Sex

Male

Sole proprietor

No

Enumerated

2020-09-06

Last updated

2021-05-12