Provider Demographics
NPI:1124092622
Name:BALUH, CHERYL L (CRNA)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:L
Last Name:BALUH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 N. SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-267-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9215427367500000X
PARN221836-L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00602487OtherRAILROAD MEDICARE
PA120420418OtherDEPT OF LABOR
FL306914100Medicaid
PA50075718OtherCAPITAL BLUECROSS
PA007380860Medicaid
PA25-1716306OtherHEALTHNET/TRICARE
PA255327OtherUNISON
PAG920-0080/85XWCUOtherCAREFIRST
PA25-1716306OtherINTERGROUP
PA050514OtherGROUP MEDICARE #
PA25-1716306OtherMULTIPLAN/PHCS
PARN221836LOtherRN LICENSE
PA50075718OtherCAPITAL BLUECROSS
PA25-1716306OtherHEALTHNET/TRICARE