Provider Demographics
NPI:1417392341
Name:BALLIET, BARBARA STRYKER (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:STRYKER
Last Name:BALLIET
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 1:7763 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-8944
Mailing Address - Country:US
Mailing Address - Phone:843-764-2212
Mailing Address - Fax:843-569-5466
Practice Address - Street 1:7763 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-8944
Practice Address - Country:US
Practice Address - Phone:843-764-2212
Practice Address - Fax:843-569-5466
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC78925163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool