Basic Information
| Provider Information | |||||||||
| NPI: | 1649329731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALLARD | ||||||||
| FirstName: | CINDA | ||||||||
| MiddleName: | JOYCE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 950257 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402950257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029696552 | ||||||||
| FaxNumber: | 5029693799 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 W HILL ST | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402082216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026363164 | ||||||||
| FaxNumber: | 5026343731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 07/02/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3857P | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 096484 | 01 | KY | SIHO - NLPCC | OTHER | 3525229000 | 01 | KY | PASSPORT ADVTG - NLPCC | OTHER | 78009719 | 05 | KY | MEDICAID | 098856 | 01 | KY | SIHO - NORTON ICC | OTHER | 000000568032 | 01 | KY | ANTHEM - NLPCC | OTHER | 50019417 | 01 | KY | PASSPORT - NLPCC | OTHER | 0042308 | 01 | KY | MEDICARE - KY - NLPCC | OTHER |