Colchado, Clarisa Ballarta

Colchado, Clarisa Ballarta is an individual health care provider with primary practice located at 433 192Nd Tank Bn Road Bldg 853, Fort Knox KY 40121-5111. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Colchado, Clarisa Ballarta can be contacted via phone (502) 624-3149.

Contact Information

Primary practice address
433 192Nd Tank Bn Road Bldg 853 Fort Knox KY 40121-5111
Phone: (502) 624-3149
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X NP95010873 California

Profile Details

NPI number 1013552140
LBN Legal business name Colchado, Clarisa Ballarta
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2019
Last updated Nov 13th, 2019 - about 6 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 1013552140 NPPES
California Other NP95010873 TRICARE INSURANCE- MILITARY

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