Provider Demographics
NPI:1578010088
Name:BALL, RAMONA M (FNP)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:M
Last Name:BALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MAXINE
Other - Middle Name:
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1227 N STATE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2002
Mailing Address - Country:US
Mailing Address - Phone:601-355-2485
Mailing Address - Fax:601-353-1463
Practice Address - Street 1:2969 CURRAN DR N
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4121
Practice Address - Country:US
Practice Address - Phone:601-974-5600
Practice Address - Fax:601-974-5699
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901726363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
545973ZXPAMedicare PIN