| NPI | 1770730392 | 
|---|---|
| Former Name | CORALYN BALCUNS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 78102) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 78102) | 
| Enumeration Date | 2008-08-26 | 
| Last Update Date | 2024-11-11 |