Provider Demographics
NPI:1760555627
Name:BALATBAT, CONCEPCION MUNGCAL (RN)
Entity Type:Individual
Prefix:MRS
First Name:CONCEPCION
Middle Name:MUNGCAL
Last Name:BALATBAT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8531 HOOES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1709
Mailing Address - Country:US
Mailing Address - Phone:703-644-0916
Mailing Address - Fax:
Practice Address - Street 1:2605 BEACON HILL RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-1611
Practice Address - Country:US
Practice Address - Phone:703-660-6440
Practice Address - Fax:703-660-8947
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001162249163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health