Individual provider · NPI-1

Jillann M Balko, CRNA

Nurse Anesthetist, Certified Registered · Morgantown, WV

NPI number1013090216
StatusActive
Last updated in NPPESApr 30, 2024

Details

NPI
1013090216
Entity type
Individual (NPI-1)
Name
Jillann M Balko
Credential
CRNA
Sex
Female
Sole proprietor
No
Enumeration date
Oct 23, 2006
Certification date
Apr 30, 2024
Last updated
Apr 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified RegisteredAPRN50514WVYes
367500000X Nurse Anesthetist, Certified Registered50514WV

Practice location

1 Medical Center Dr
Morgantown, WV 26506-1200

Phone 304-598-4122

Mailing address

1370 Johnson Ave Ste 102
Bridgeport, WV 26330-1492

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