Provider Demographics
NPI:1952705956
Name:BALI, CHINTI X (NP)
Entity Type:Individual
Prefix:MRS
First Name:CHINTI
Middle Name:X
Last Name:BALI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE STREET NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30808
Mailing Address - Country:US
Mailing Address - Phone:404-686-2500
Mailing Address - Fax:404-686-4479
Practice Address - Street 1:550 PEACHTREE STREET NE
Practice Address - Street 2:4-4269
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30808
Practice Address - Country:US
Practice Address - Phone:404-686-2500
Practice Address - Fax:404-686-4479
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052629363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care