MEDICARE: KIRSTEN BALIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	202114190	OR

General Provider Information

NPI Number	:	1538812979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN BALIN

Provider Business Mailing Address
First Line	:	6062 OCONNER RD
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9722
Country	:	US
Telephone Number	:	541-892-4012
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1129
Country	:	US
Telephone Number	:	541-274-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	08/15/2023

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Directions to “ KIRSTEN BALIN ” Practice Location

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