Provider Demographics
NPI:1568094969
Name:BALINO, JOSEL (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JOSEL
Middle Name:
Last Name:BALINO
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 NW FLINTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:MO
Mailing Address - Zip Code:64150-3500
Mailing Address - Country:US
Mailing Address - Phone:816-582-4775
Mailing Address - Fax:
Practice Address - Street 1:901 E 104TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4517
Practice Address - Country:US
Practice Address - Phone:816-599-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79116-121363LF0000X
MO2019045211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily