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1295721439

NPI Code Detail

MEDICARE: ANDREA BALAZS ARNP

MEDICARE: ANDREA BALAZS ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP30003720	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	500008540	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BA1773	OTHER		ASURIS NW HEALTH
2	000010143137	OTHER		BLUE SHIELD OF IDAHO
3	129923	OTHER	WA	LABOR & INDUSTRIES
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295721439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BALAZS ARNP

Provider Business Mailing Address
First Line	:	PO BOX 3649
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99220
Country	:	US
Telephone Number	:	509-838-2531
Fax Number	:	509-755-6580

Provider Business Practice Location Address
First Line	:	12410 E SINTO AVE STE 101
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-2258
Country	:	US
Telephone Number	:	509-838-2531
Fax Number	:	509-755-6580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/21/2022

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Directions to “ ANDREA BALAZS ARNP” Practice Location

Language	Start Address	Practice Location

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