Provider Demographics
NPI:1033717228
Name:BAXTER PALLIATIVE CONSULTING LLC
Entity Type:Organization
Organization Name:BAXTER PALLIATIVE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, ACHPN
Authorized Official - Phone:401-400-5535
Mailing Address - Street 1:55 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3617
Mailing Address - Country:US
Mailing Address - Phone:401-400-5535
Mailing Address - Fax:
Practice Address - Street 1:55 CHERRY LN
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3617
Practice Address - Country:US
Practice Address - Phone:401-400-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty