Individual
DR. JUSTIN E BALA-HAMPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, MPH, AGACNP-BC
Contact information
Practice address
8081 INNOVATION PARK DR, FAIRFAX, VA 22031-4867
(571) 472-4724
(571) 472-0241
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024178204
VA
363L00000X
Nurse Practitioner
AP131676/RN 905070
TX
363LA2100X
Acute Care Nurse Practitioner
0024178204
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024178204
VA BOARD OF MEDICINE
VA
05
—
365493101
—
TX
Enumeration date
10/19/2016
Last updated
11/27/2023
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