Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 244108 | MA |
Y | 363LC1500X | Nurse Practitioner - Community Health | ARNP9286548 | FL |
NPI | 1265567051 |
---|---|
Provider Name | Pami Lee Ball-Pella |
First Address | Sumterville, FL 33585-5141 |
Second Address | Ocala, FL 34472-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 17/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000928300 | (05) | FL |
P51662 | (02) | MA |
Y137P | BCBS (01) | FL |