Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD11509 | RI |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01083060A | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2019013060 | MO |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 231751 | MA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 58308 | AZ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 64452 | CT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | D79151 | MD |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD042914 | DC |
N | 207VX0000X | Obstetrician | 231751 | MA |
NPI | 1164498218 |
---|---|
Provider Name | Jennifer E Ballard |
First Address | Wilmington, DE 19807-2018 |
Second Address | Greenwich, CT 06830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 25/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110077577A | (05) | MA |