Provider Demographics
NPI:1043843964
Name:BALENADA, EMILY NOEL (RN60028557)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NOEL
Last Name:BALENADA
Suffix:
Gender:F
Credentials:RN60028557
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:NOEL
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN60028557
Mailing Address - Street 1:12121 E MISSION AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4832
Mailing Address - Country:US
Mailing Address - Phone:509-443-3102
Mailing Address - Fax:509-474-1792
Practice Address - Street 1:12121 E MISSION AVE STE C
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4832
Practice Address - Country:US
Practice Address - Phone:509-443-3102
Practice Address - Fax:509-474-1792
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60028557163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN60028557Medicaid