Provider Demographics
NPI:1194611301
Name:BALKIN, EMMA (RN)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BALKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11006 GAITHER FARM RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6125
Mailing Address - Country:US
Mailing Address - Phone:443-889-5963
Mailing Address - Fax:
Practice Address - Street 1:418 CURIE BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4217
Practice Address - Country:US
Practice Address - Phone:443-889-5963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR265167163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse