Healthcare Provider Details

I. General information

NPI: 1972924405
Provider Name (Legal Business Name): BARBARA STEVEN BALCH RN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD CENTRAL VT MEDICAL CENTER
BERLIN VT
05663
US

IV. Provider business mailing address

PO BOX 547 CENTRAL VT MEDICAL CENTER
BARRE VT
05641
US

V. Phone/Fax

Practice location:
  • Phone: 802-371-4415
  • Fax: 802-371-5347
Mailing address:
  • Phone: 802-371-4415
  • Fax: 802-371-5347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number026.0017155
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number10623322
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: