MEDICARE: MRS. TORI NICOLE BALSER FNP-C

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	11096388-4405	UT

General Provider Information

NPI Number	:	1437028305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TORI NICOLE BALSER FNP-C

Provider Business Mailing Address
First Line	:	1055 N 500 W
Second Line	:	ATT: CREDENTIALING
City	:	PROVO
State	:	UT
Zip	:	84604-3305
Country	:	US
Telephone Number	:	801-354-8225
Fax Number	:	801-418-0941

Provider Business Practice Location Address
First Line	:	1055 N 500 W BLDG A
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3305
Country	:	US
Telephone Number	:	801-812-5033
Fax Number	:

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

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	12/02/2025

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