Provider Demographics
NPI:1235332545
Name:BALON, JENNIFER ANNE (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:BALON
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
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Mailing Address - Street 1:124 KEAFER RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-5512
Mailing Address - Country:US
Mailing Address - Phone:814-534-3610
Mailing Address - Fax:814-534-5636
Practice Address - Street 1:MEMORIAL MEDICAL CENTER
Practice Address - Street 2:1086 FRANKLIN ST.
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905
Practice Address - Country:US
Practice Address - Phone:814-534-3610
Practice Address - Fax:814-534-5636
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP005649B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner