Provider Demographics
NPI:1487311841
Name:BALBI, MICHELLE BRALOW (CRNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BRALOW
Last Name:BALBI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7637 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-3152
Mailing Address - Country:US
Mailing Address - Phone:610-844-7229
Mailing Address - Fax:
Practice Address - Street 1:415 BUSINESS PARK LN
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9120
Practice Address - Country:US
Practice Address - Phone:610-844-7229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024537363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology