Provider Demographics
NPI:1922634351
Name:BALL, JOANN MCRAE (NP)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:MCRAE
Last Name:BALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:43635 RECLINATA WAY
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-1851
Mailing Address - Country:US
Mailing Address - Phone:760-861-7738
Mailing Address - Fax:760-341-9872
Practice Address - Street 1:72855 FRED WARING DR STE A6
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-9369
Practice Address - Country:US
Practice Address - Phone:760-341-6800
Practice Address - Fax:760-341-9872
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95014226363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care