Provider Demographics
NPI:1366466088
Name:BALDWIN, HOLLY ANN (RN, APN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SHREWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1250
Mailing Address - Country:US
Mailing Address - Phone:732-212-0777
Mailing Address - Fax:
Practice Address - Street 1:211 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1250
Practice Address - Country:US
Practice Address - Phone:732-212-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00113900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ73531Medicare UPIN