=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528872538
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BALANCE WOMENS HEALTHCARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2025
-----------------------------------------------------
Last Update Date | 02/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1055 N 300 W STE 108
-----------------------------------------------------
City | PROVO
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84604-3381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-357-7377
-----------------------------------------------------
Fax | 801-357-7378
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1055 N 300 W STE 108
-----------------------------------------------------
City | PROVO
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84604-3381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-357-7377
-----------------------------------------------------
Fax | 801-357-7378
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER
-----------------------------------------------------
Name | ANDREA DRIGGS
-----------------------------------------------------
Credential | DNP
-----------------------------------------------------
Telephone | 801-319-4245
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------