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Mark Richard Baller, CRNA

Nurse Anesthetist, Certified Registered in Lone Tree, CO. Individual provider (NPI-1).

NPI number1083671986
StatusActive
Last updated in NPPESOct 4, 2007

Details

NPI
1083671986
Entity type
Individual (NPI-1)
Name
Mark Richard Baller
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Apr 26, 2006
Last updated
Oct 4, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered175201COYes
367500000X Nurse Anesthetist, Certified Registered541986TX

Practice location

10102 Bluffmont Ln
Lone Tree, CO 80124-5570

Phone 303-799-6859

Mailing address

10102 Bluffmont Ln
Lone Tree, CO 80124-5570

Phone 303-799-6859

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