Healthcare Provider Details

I. General information

NPI: 1053275172
Provider Name (Legal Business Name): RITU BALA RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 EKATERINA CT
CHESAPEAKE VA
23322-8924
US

IV. Provider business mailing address

1020 EKATERINA CT
CHESAPEAKE VA
23322-8924
US

V. Phone/Fax

Practice location:
  • Phone: 347-583-2948
  • Fax:
Mailing address:
  • Phone: 347-583-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001299298
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024195620
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: