Provider Demographics
NPI:1477387900
Name:BALL, JAMIE LEE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:BALL
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 1:2320 S JACKSON AVE APT 40A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-3057
Mailing Address - Country:US
Mailing Address - Phone:918-313-6652
Mailing Address - Fax:
Practice Address - Street 1:2320 S JACKSON AVE APT 40A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-3057
Practice Address - Country:US
Practice Address - Phone:918-313-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program