Provider Demographics
NPI:1265038020
Name:BAL, APNEET KAUR (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:APNEET
Middle Name:KAUR
Last Name:BAL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7134 BALSAM CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5826
Mailing Address - Country:US
Mailing Address - Phone:586-484-1665
Mailing Address - Fax:
Practice Address - Street 1:1455 S LAPEER RD STE 102
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1468
Practice Address - Country:US
Practice Address - Phone:248-232-0100
Practice Address - Fax:248-232-0100
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704325953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily