Provider Demographics
NPI:1447053376
Name:BALLE, ALEXANDRA MICHELLE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:BALLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 HAYDEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-3233
Mailing Address - Country:US
Mailing Address - Phone:614-816-5298
Mailing Address - Fax:
Practice Address - Street 1:3134 HAYDEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-3233
Practice Address - Country:US
Practice Address - Phone:614-816-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty