Provider Demographics
NPI:1235403015
Name:BALL, EMILY RENE' (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:RENE'
Last Name:BALL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:RENE'
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5100 PRAIRIE PKWY
Mailing Address - Street 2:STE 301
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-277-1990
Mailing Address - Fax:319-222-2999
Practice Address - Street 1:5100 PRAIRIE PKWY
Practice Address - Street 2:STE 301
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-277-1990
Practice Address - Fax:319-222-2999
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-114265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA719260496Medicare PIN