Individual
KYLA S BALZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2020 S WEBSTER AVE, GREEN BAY, WI 54301-2291
(920) 445-7210
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11385-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021033573
AMERICAN NURSES CREDENTIALING CENTER
—
Enumeration date
10/11/2021
Last updated
03/07/2023
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