Provider Demographics
NPI:1124239405
Name:BALL, CAROL ANN CLANCY (FNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL ANN
Middle Name:CLANCY
Last Name:BALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:106 STONEHEDGE DRIVE NORTH
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831
Mailing Address - Country:US
Mailing Address - Phone:203-532-0281
Mailing Address - Fax:203-532-0282
Practice Address - Street 1:919 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-968-1900
Practice Address - Fax:914-968-5854
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330843363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily