Provider Demographics
NPI:1164582979
Name:BALL, JUANITA (RN)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 TECHNOLOGY WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2009
Mailing Address - Country:US
Mailing Address - Phone:775-687-7573
Mailing Address - Fax:775-687-7544
Practice Address - Street 1:3595 HWY 50 WEST
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429
Practice Address - Country:US
Practice Address - Phone:775-577-0319
Practice Address - Fax:775-577-9571
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRNZ8899163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse