Individual
AUDREY LYNN BALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
44045 RIVERSIDE PKWY, LEESBURG, VA 20176-5101
(703) 858-6490
(571) 291-9263
Mailing address
17 RUNNING BROOK LN, STERLING, VA 20164-1167
(248) 881-6828
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024196013
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
04/03/2026
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