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Individual

CHRISTA RUBLE BALANOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10787 NALL AVE, SUITE 220, OVERLAND PARK, KS 66211-1375
(913) 945-9400
(913) 945-9410
Mailing address
10787 NALL AVE, SUITE 220, OVERLAND PARK, KS 66211-1375
(913) 945-9400
(913) 945-9410

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
04-31985
KS
208600000X
Surgery Physician
2006018662
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1009224
TRICARE
IN
05
200195500
IN
Enumeration date
07/18/2005
Last updated
11/25/2014
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