Provider Demographics
NPI:1497520514
Name:BALIKO, KIMBERLEY SUE
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:SUE
Last Name:BALIKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HAMPI CT
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1613
Mailing Address - Country:US
Mailing Address - Phone:810-814-4542
Mailing Address - Fax:
Practice Address - Street 1:19 HAMPI CT
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1613
Practice Address - Country:US
Practice Address - Phone:810-814-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care