Most Relevant Information
Provider Data
| NPI Number: | 1003235284 |
| Provider Name: | KEISHA A BALLENTINE-CARGILL FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | F338198-1 |
Most Important Dates
| Enumeration Date: | 04/15/2014 |
| Last Updated: | 07/06/2023 |
Provider Practice Location
841 BURKE AVE
BRONX
NY
104676619
Practice Location Phone/Fax
| Phone: | 7186541726 |
| Fax: |
Provider Mailing Location
1054 E 231ST ST
BRONX
NY
104664806
Provider Mailing Phone/Fax
| Phone: | 7186526791 |
| Fax: |