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Individual
NICOLE LEE BALCHUNE
Active
Individual
NICOLE LEE BALCHUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS014813
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440771
MEDICARE AA #
PA
Enumeration date
05/14/2009
Last updated
06/13/2023
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