Individual provider · Type 1 NPI
Nicollette Louise Black-Ballard, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Norcross, GA
NPI number
1083439541
Active
Practice location
5127 Jimmy Carter Blvd Ste 205
Norcross, GA 30093-1619
Mailing address
2915 Ilir Mnr NW
Atlanta, GA 30318-2231
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 290443 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1083439541
Nicollette Louise Black-Ballard, PMHNP's National Provider Identifier is 1083439541, issued on Nov 20, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Norcross, GA. The record was last updated on Jan 9, 2025.