Provider Demographics
NPI:1861147795
Name:BALL, FIONA CHRISTINA (BS)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:CHRISTINA
Last Name:BALL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 STONEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-8903
Mailing Address - Country:US
Mailing Address - Phone:240-547-7159
Mailing Address - Fax:
Practice Address - Street 1:100 NORMAL ROAD
Practice Address - Street 2:RM 86
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-3004
Practice Address - Country:US
Practice Address - Phone:815-753-0591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program