Provider Demographics
NPI:1013213719
Name:BALERIA, EVELYN D (APRN, CNS, RXN)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:D
Last Name:BALERIA
Suffix:
Gender:F
Credentials:APRN, CNS, RXN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 W COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-3325
Mailing Address - Country:US
Mailing Address - Phone:719-226-0659
Mailing Address - Fax:719-226-0753
Practice Address - Street 1:2212 W COLORADO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3325
Practice Address - Country:US
Practice Address - Phone:719-226-0659
Practice Address - Fax:719-226-0753
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81050163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health