Provider Demographics
NPI:1811726680
Name:BALL, MEGAN DAWN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DAWN
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 1:404 LITTLE COVE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:WV
Mailing Address - Zip Code:26443-7810
Mailing Address - Country:US
Mailing Address - Phone:304-406-4222
Mailing Address - Fax:
Practice Address - Street 1:404 LITTLE COVE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:WV
Practice Address - Zip Code:26443-7810
Practice Address - Country:US
Practice Address - Phone:304-406-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41557164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse