Healthcare Provider Details

I. General information

NPI: 1568094969
Provider Name (Legal Business Name): JOSEL BALINO MSN, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 05/13/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16990 W 86TH ST STE 100
LENEXA KS
66219
US

IV. Provider business mailing address

16990 W 86TH ST STE 100
LENEXA KS
66219
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-8400
  • Fax: 913-599-1682
Mailing address:
  • Phone: 913-676-8400
  • Fax: 913-599-1682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2019045211
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-79116-121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: