Vergena Raeonda Ballenger

NPI #1245584762 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1245584762
Entity Type: Individual
Name: Vergena Raeonda Ballenger
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: Nov 6, 2012
Last Updated: Nov 6, 2012

Practice Location

Address: 3001 WARRIOR LN
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-8685
Phone: (573) 686-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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