Baller, Mark Richard

Baller, Mark Richard is an individual health care provider with primary practice located at 10102 Bluffmont Ln , Lone Tree CO 80124-5570. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Baller, Mark Richard can be contacted via phone (303) 799-6859.

Contact Information

Primary practice address
10102 Bluffmont Ln Lone Tree CO 80124-5570
Phone: (303) 799-6859
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 541986 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 175201 Colorado

Profile Details

NPI number 1083671986
LBN Legal business name Baller, Mark Richard
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Oct 4th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083671986 NPPES
Colorado MEDICAID 77228219

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