Provider Demographics
NPI:1649082009
Name:FEDERICO BALLARD, RHONDA ASHLEY (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ASHLEY
Last Name:FEDERICO BALLARD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3446 LULLWATER LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-6937
Mailing Address - Country:US
Mailing Address - Phone:904-894-5698
Mailing Address - Fax:
Practice Address - Street 1:3446 LULLWATER LN
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-6937
Practice Address - Country:US
Practice Address - Phone:904-894-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily