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Contact Information

WILLIE B BALLOU, NP-C
4041 S MCCLINTOCK DR
TEMPE, AZ85282-5879
 Phone: 520-233-7111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Adult Health

363LA2200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for WILLIE B BALLOU · (Male)

NPI # 1548657802
Status Active
Credentials NP-C (Nurse Practitioner - Certified)
Entity Individual
Enumeration date 04/23/2015
Last updated 07/07/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 229136
  • TX License # AP127755
Hospital affiliation(s) Not Available
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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