Provider Demographics
NPI:1396040465
Name:BALLARD, LAURA ALLISON (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ALLISON
Last Name:BALLARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ALLISON
Other - Last Name:SALMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13100 MEADOWBREEZE DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-2013
Mailing Address - Country:US
Mailing Address - Phone:561-603-4748
Mailing Address - Fax:
Practice Address - Street 1:10155 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1404
Practice Address - Country:US
Practice Address - Phone:561-204-2349
Practice Address - Fax:561-792-2045
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9263559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily