Provider Demographics
NPI:1225627326
Name:BALLEW, LINDSEY (NP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BALLEW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 BERT KOUNS INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8150
Mailing Address - Country:US
Mailing Address - Phone:318-683-0411
Mailing Address - Fax:318-683-0743
Practice Address - Street 1:424 DIXIE PLZ
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5881
Practice Address - Country:US
Practice Address - Phone:318-352-6883
Practice Address - Fax:318-356-0732
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA218207164W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse