Individual provider · NPI-1

Katelynn Anne Balot, NP

Nurse Practitioner, Family · Mineola, NY

NPI number1740761683
StatusActive
Last updated in NPPESDec 29, 2021

Details

NPI
1740761683
Entity type
Individual (NPI-1)
Name
Katelynn Anne Balot
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 28, 2018
Certification date
Dec 29, 2021
Last updated
Dec 29, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family343342NYYes

Practice location

120 Mineola Blvd Ste 210
Mineola, NY 11501-4077

Phone 516-663-4600

Mailing address

120 Mineola Blvd Ste 210
Mineola, NY 11501-4077

Phone 516-663-4600

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