Provider Demographics
NPI:1063635365
Name:CARDENAS-BALL, AURORA (NP)
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:
Last Name:CARDENAS-BALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AURORA
Other - Middle Name:G
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1835 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-5210
Mailing Address - Country:US
Mailing Address - Phone:937-323-9242
Mailing Address - Fax:
Practice Address - Street 1:1835 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-5210
Practice Address - Country:US
Practice Address - Phone:937-323-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA12314363LX0001X
AZRN047904363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062287Medicaid