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General NPI Number Information
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NPI Number | 1366067373
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Entity Type | Individual
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Provider Name | LUKE BALMER
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Gender | Male
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 9000 STONY POINT PKWY
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City | RICHMOND
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State | VA
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Zip | 23235-1900
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Country | US
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Telephone | 804-828-2161
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Fax | 804-998-1255
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Provider Business Mailing Address
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Address Line | 9000 STONY POINT PKWY
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City | RICHMOND
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State | VA
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Zip | 23235-1900
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Country | US
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Telephone | 804-828-2161
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Fax | 804-998-1255
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG06200129
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 0024179499
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024179499
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License Number State | VA
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