Healthcare Provider Details

I. General information

NPI: 1992242309
Provider Name (Legal Business Name): MONIQUE BALFOUR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 N PEARL ST
BROCKTON MA
02301-1708
US

IV. Provider business mailing address

34 N PEARL ST
BROCKTON MA
02301-1708
US

V. Phone/Fax

Practice location:
  • Phone: 857-397-2009
  • Fax:
Mailing address:
  • Phone: 508-408-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2280851
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: