MEDICARE: DEBORAH ANN BALEY WHCNP-G

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	364SW0102X	Women's Health Clinical Nurse Specialist	597683	TX

General Provider Information

NPI Number	:	1811170319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH ANN BALEY WHCNP-G

Provider Business Mailing Address
First Line	:	7424 GREENVILLE AVE
Second Line	:	SUITE 206
City	:	DALLAS
State	:	TX
Zip	:	75231-4552
Country	:	US
Telephone Number	:	214-363-2004
Fax Number	:	214-696-2091

Provider Business Practice Location Address
First Line	:	7424 GREENVILLE AVE
Second Line	:	SUITE 206
City	:	DALLAS
State	:	TX
Zip	:	75231-4552
Country	:	US
Telephone Number	:	214-363-2004
Fax Number	:	214-696-2091

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

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	12/07/2007

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