Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | APRN.CNP.024895 | OH |
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN.CNP.024895 | OH |
NPI | 1417612102 |
---|---|
Provider Name | Kathryn Danielle Balcom |
First Address | Cincinnati, OH 45206-1785 |
Second Address | West Chester, OH 45069-2509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2021 |
Last Update Date | 10/11/2021 |