Individual
MR. TIMOTHY ALAN BALISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
301 MCCULLOUGH DR STE 520, CHARLOTTE, NC 28262-1336
(704) 332-8787
(704) 332-8788
Mailing address
5426 BEDFORDSHIRE AVE, HARRISBURG, NC 28075-9384
(951) 310-4957
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5016133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5016133
BOARD OF NURSING
NC
Enumeration date
05/02/2022
Last updated
04/07/2025
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