Provider Demographics
NPI:1790339224
Name:BALL, COLEEN M
Entity Type:Individual
Prefix:MS
First Name:COLEEN
Middle Name:M
Last Name:BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6501 E GREENWAY PKWY
Mailing Address - Street 2:STE. 103 PMB 324
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:877-798-2921
Mailing Address - Fax:855-734-3373
Practice Address - Street 1:6501 E GREENWAY PKWY
Practice Address - Street 2:STE. 103 PMB 324
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:877-798-2921
Practice Address - Fax:855-734-3373
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374U00000XNursing Service Related ProvidersHome Health Aide