Provider Demographics
NPI:1477261360
Name:BALSDON, EMILY A (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:A
Last Name:BALSDON
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 1:208 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANGDON
Mailing Address - State:ND
Mailing Address - Zip Code:58249-2225
Mailing Address - Country:US
Mailing Address - Phone:701-740-4911
Mailing Address - Fax:
Practice Address - Street 1:164 W 13TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1826
Practice Address - Country:US
Practice Address - Phone:701-352-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDF10220026363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care