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Individual
JACQUELINE BALON
Active
Individual
JACQUELINE BALON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704100757
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0866685
BCBSM
—
01
—
13834
MCARE
MI
05
—
4362714
—
MI
05
—
4790050
—
MI
01
—
P30273
HEALTH ALLIANCE PLAN
—
Enumeration date
04/12/2006
Last updated
09/12/2007
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