Individual provider · Type 1 NPI
Jill Ballantine, AGACNP
Gerontology Nurse Practitioner · Dubuque, IA
NPI number
1073979555
Active
Practice location
250 Mercy Dr
Dubuque, IA 52001-7320
Fax (563) 584-3227
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | H098201 (IA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1073979555
Jill Ballantine, AGACNP's National Provider Identifier is 1073979555, issued on Jan 13, 2016. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Dubuque, IA. The record was last updated on Jan 13, 2016.