Provider Demographics
NPI:1053786756
Name:BALAO, JOSEPH PATRICK ELTANAL (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:JOSEPH PATRICK
Middle Name:ELTANAL
Last Name:BALAO
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Gender:M
Credentials:MSN, CRNP
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Mailing Address - Street 1:1800 ORLEANS ST
Mailing Address - Street 2:ZAYED TOWER, SUITE 7125-L
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0010
Mailing Address - Country:US
Mailing Address - Phone:410-502-2533
Mailing Address - Fax:410-630-7491
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:ZAYED TOWER, SUITE 7125-L
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-502-2533
Practice Address - Fax:410-630-7491
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR165241363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology