Provider Demographics
NPI:1437916210
Name:BALUYOT, ABIGAIL MAGUAD (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MAGUAD
Last Name:BALUYOT
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18160 PARKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-8146
Mailing Address - Country:US
Mailing Address - Phone:734-394-6267
Mailing Address - Fax:
Practice Address - Street 1:18160 PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-8146
Practice Address - Country:US
Practice Address - Phone:734-394-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704282146363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner