Provider Demographics
NPI:1467234864
Name:BALDWIN, JENNA CATHERINE
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:CATHERINE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1540
Mailing Address - Country:US
Mailing Address - Phone:316-217-7488
Mailing Address - Fax:
Practice Address - Street 1:1 KELLOGG CIR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-5087
Practice Address - Country:US
Practice Address - Phone:316-217-7488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer