Provider Demographics
NPI:1174967400
Name:BALLARD, NEDA QUILANTANG (ADV PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:NEDA
Middle Name:QUILANTANG
Last Name:BALLARD
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Gender:F
Credentials:ADV PRACTITIONER
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Mailing Address - Street 1:3750 S JONES BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2208
Mailing Address - Country:US
Mailing Address - Phone:702-876-0350
Mailing Address - Fax:702-847-7437
Practice Address - Street 1:3750 S JONES BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2208
Practice Address - Country:US
Practice Address - Phone:702-876-0350
Practice Address - Fax:702-847-7437
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN001492363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner