Provider Demographics
NPI:1295989556
Name:BALLENTINE, HOPE ALLYSON (RN, CNM)
Entity type:Individual
Prefix:MISS
First Name:HOPE
Middle Name:ALLYSON
Last Name:BALLENTINE
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Gender:F
Credentials:RN, CNM
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Mailing Address - Street 1:614 E EMMA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-4634
Mailing Address - Country:US
Mailing Address - Phone:479-751-7417
Mailing Address - Fax:479-751-4898
Practice Address - Street 1:1233 WEST POPLAR STREET
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-4245
Practice Address - Country:US
Practice Address - Phone:479-636-9235
Practice Address - Fax:479-631-0374
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2011-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARM02110 CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178530799Medicaid