Provider Demographics
NPI:1376203687
Name:BALLENSKY, JULIE (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BALLENSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 HIGHWAY 49 N
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:ND
Mailing Address - Zip Code:58523-6038
Mailing Address - Country:US
Mailing Address - Phone:701-873-4445
Mailing Address - Fax:701-873-4466
Practice Address - Street 1:1312 HIGHWAY 49 N
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:ND
Practice Address - Zip Code:58523-6038
Practice Address - Country:US
Practice Address - Phone:701-873-4445
Practice Address - Fax:701-873-4466
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28609163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator