Vicki Lynn Balchikonis, LPN

Individual provider Active NPI Licensed Practical Nurse · Montrose, PA

NPI 1780178566 · NPPES record last updated Jun 15, 2018

Key facts

NPI
1780178566
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
246305-1 (NY)
Practice address
2954 North Rd
Montrose, PA 18801-9595
Phone
(570) 278-4157
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
246305-1NYMDLicensed Practical Nurse
PN268756PAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN268756 PA
Licensed Practical Nurse 164W00000X 246305-1 NY Yes

Addresses

Primary practice location

2954 North Rd
Montrose, PA 18801-9595

Mailing address

2954 North Rd
Montrose, PA 18801-9595
Phone (570) 278-4157

Other providers in Montrose, PA

All providers in Montrose, PA · Licensed Practical Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.