Provider Demographics
NPI:1285322594
Name:LIFE BALANCE PLLC
Entity type:Organization
Organization Name:LIFE BALANCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:662-640-4004
Mailing Address - Street 1:2887 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5433
Mailing Address - Country:US
Mailing Address - Phone:662-638-8997
Mailing Address - Fax:
Practice Address - Street 1:405 GALLERIA DR STE E
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4717
Practice Address - Country:US
Practice Address - Phone:662-640-4004
Practice Address - Fax:662-238-4122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty