National Provider Identifier Database

ANGELES L BALLOU, FNP – NPI #1093863433
Family


Contact Information

ANGELES L BALLOU, FNP
444 W FORT ST FL 2
BOISE, ID83702-4535
Phone: 208-422-1018
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for ANGELES L BALLOU

NPI Number 1093863433
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 01/08/2007
Last updated 06/23/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • AL License #: 1-112187
  • MS License #: R854737
  • MS Medicaid: PENDING
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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