Provider Demographics
NPI:1750278107
Name:BALLARD, EMISHA
Entity type:Individual
Prefix:
First Name:EMISHA
Middle Name:
Last Name:BALLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3966 CHIMNEY SWIFTS LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-8751
Mailing Address - Country:US
Mailing Address - Phone:904-483-0272
Mailing Address - Fax:
Practice Address - Street 1:3966 CHIMNEY SWIFTS LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8751
Practice Address - Country:US
Practice Address - Phone:904-483-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula