Provider Demographics
NPI:1801692421
Name:BALL, CONSTANCE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:
Last Name:BALL
Suffix:
Gender:
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-4449
Mailing Address - Country:US
Mailing Address - Phone:205-454-1013
Mailing Address - Fax:
Practice Address - Street 1:2116 PARK ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-4449
Practice Address - Country:US
Practice Address - Phone:205-454-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 372600000X, 376J00000X
AL1-072340163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker