Shannon Marie Balog, DNP, FNP-C
Nurse Practitioner, Family in Cleveland, OH. Individual provider (NPI-1).
NPI number1982171500
StatusActive
Last updated in NPPESNov 1, 2018
Details
- NPI
- 1982171500
- Entity type
- Individual (NPI-1)
- Name
- Shannon Marie Balog
- Credential
- DNP, FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 1, 2018
- Last updated
- Nov 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN.CNP.023210 | OH | Yes |
Practice location
18101 Lorain AveCleveland, OH 44111-5612
Phone 216-889-6412
Mailing address
312 N Lake StSouth Amherst, OH 44001-2828
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