Provider Demographics
NPI:1366881302
Name:BALELO, CHRISTINA MARIA (APN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:BALELO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIA
Other - Last Name:NAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:8906 SPANISH RIDGE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1319
Mailing Address - Country:US
Mailing Address - Phone:702-330-3102
Mailing Address - Fax:702-912-4994
Practice Address - Street 1:2580 SAINT ROSE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7777
Practice Address - Country:US
Practice Address - Phone:702-862-8862
Practice Address - Fax:702-862-8774
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001524363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1366881302Medicaid