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General NPI Number Information
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NPI Number | 1639775281
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Entity Type | Individual
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Provider Name | ANNETTE BALE APRN
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Gender | Female
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 6525 GREEN BAY RD
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City | KENOSHA
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State | WI
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Zip | 53142-2967
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Country | US
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Telephone | 877-201-0290
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Fax | 262-821-6180
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Provider Business Mailing Address
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Address Line | 3010 GRAND AVE
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City | WAUKEGAN
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State | IL
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Zip | 60085-2321
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Country | US
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Telephone | 847-377-8950
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 121496-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 041.273400
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209024477
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 16340-33
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License Number State | WI
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