Individual
ALICIA JENNIFER BALDASSARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
3701 GRAPEVINE MILLS PKWY APT 2526, GRAPEVINE, TX 76051-1939
(201) 230-3376
Mailing address
3701 GRAPEVINE MILLS PKWY APT 2526, GRAPEVINE, TX 76051-1939
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
807308
TX
163W00000X
Registered Nurse
RN621735
PA
363LF0000X
Family Nurse Practitioner
Primary
AP135439
TX
363LF0000X
Family Nurse Practitioner
CNP 4887
MN
363LF0000X
Family Nurse Practitioner
R 241060-1
MN
Other
Enumeration date
07/26/2016
Last updated
04/16/2018
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