Provider Demographics
NPI:1518108455
Name:BALAN, GERARD JR (APRN, CNP)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:
Last Name:BALAN
Suffix:JR
Gender:M
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4159
Mailing Address - Country:US
Mailing Address - Phone:612-810-6414
Mailing Address - Fax:802-210-4139
Practice Address - Street 1:3507 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4159
Practice Address - Country:US
Practice Address - Phone:612-810-6414
Practice Address - Fax:802-210-4139
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 1148363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health