Provider Demographics
NPI:1063237022
Name:BALDE, DJENABA OURY (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DJENABA
Middle Name:OURY
Last Name:BALDE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:THIERNO
Other - Middle Name:DJENABA OURY
Other - Last Name:BALDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18097 E 53RD DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8812
Mailing Address - Country:US
Mailing Address - Phone:720-421-4464
Mailing Address - Fax:
Practice Address - Street 1:18097 E 53RD DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8812
Practice Address - Country:US
Practice Address - Phone:720-421-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1699554163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse