Provider Demographics
NPI:1972005379
Name:BALL, ESTHER JANE (LPN)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:JANE
Last Name:BALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 NADEAU RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-9290
Mailing Address - Country:US
Mailing Address - Phone:734-735-8230
Mailing Address - Fax:
Practice Address - Street 1:524 NADEAU RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-9290
Practice Address - Country:US
Practice Address - Phone:734-735-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703096631164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse