Individual
DANETTA BALANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
163 TOWNSHIP ROAD 1336, SOUTH POINT, OH 45680-7890
(740) 442-8996
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
1162852
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1162852
REGISTERED NURSE
KY
Enumeration date
04/06/2022
Last updated
04/06/2022
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