| Doctor Name: | MR. STEVEN R BALLARD |
| NPI Number: | 1043454564 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ANP |
| License Number: | 105523 |
| Business Practice Address: | 1050 W 10th St Ste 500 Rolla, MO - 654012905 |
| Business Phone Number: | 5733081301 |
| Business Fax Number: | 5733081305 |
| Mailing Address: | 1050 W 10th St, ROLLA |
| State: | MO |
| Postal Code: | 654012905 |
| Phone Number: | 5734583389 |
| Fax Number: | 5734262282 |
| NPI Enumeration Date: | 04/28/2009 |
| NPI Last Update Date: | 08/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 105523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |