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General NPI Number Information
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NPI Number | 1235332545
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Entity Type | Individual
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Provider Name | JENNIFER ANNE BALON MSN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | MEMORIAL MEDICAL CENTER 1086 FRANKLIN ST.
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City | JOHNSTOWN
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State | PA
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Zip | 15905
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Country | US
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Telephone | 814-534-3610
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Fax | 814-534-5636
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Provider Business Mailing Address
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Address Line | 124 KEAFER RD
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City | JOHNSTOWN
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State | PA
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Zip | 15905-5512
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Country | US
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Telephone | 814-534-3610
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Fax | 814-534-5636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP005649B
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License Number State | PA
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