Healthcare Provider Details

I. General information

NPI: 1366208647
Provider Name (Legal Business Name): ALAINA NICOLE BALDNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5408 NW 88TH ST STE 140
JOHNSTON IA
50131-2953
US

IV. Provider business mailing address

5408 NW 88TH ST STE 140
JOHNSTON IA
50131-2953
US

V. Phone/Fax

Practice location:
  • Phone: 515-368-7504
  • Fax:
Mailing address:
  • Phone: 515-368-7504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number128903
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: