Provider Demographics
NPI:1417191685
Name:BALL, STEVEN VINCENT (CRNA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:VINCENT
Last Name:BALL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-0706
Mailing Address - Country:US
Mailing Address - Phone:603-481-8757
Mailing Address - Fax:603-238-2163
Practice Address - Street 1:16 HOSPITAL RD
Practice Address - Street 2:PLYMOUTH ANESTHESIA
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1126
Practice Address - Country:US
Practice Address - Phone:603-536-1120
Practice Address - Fax:603-238-6409
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH062420-23367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3072230Medicaid