Provider Demographics
NPI:1497419766
Name:BALDWIN, CIARA ANNETTE
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:ANNETTE
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 1:1471 DI BLASI DR APT 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-2600
Mailing Address - Country:US
Mailing Address - Phone:510-998-6331
Mailing Address - Fax:
Practice Address - Street 1:1771EAST FLAMINGO RD STE220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NEVADA
Practice Address - Zip Code:89119
Practice Address - Country:UM
Practice Address - Phone:702-560-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7159704372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion