Provider Demographics
NPI:1497758601
Name:BALDWIN, KATHLEEN M (ANP, GNP, CNS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:ANP, GNP, CNS
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP, GNP, CNS
Mailing Address - Street 1:7029 BRIERHILL CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-7111
Mailing Address - Country:US
Mailing Address - Phone:817-257-6748
Mailing Address - Fax:817-257-7944
Practice Address - Street 1:2800 WEST BOWIE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76129-0001
Practice Address - Country:US
Practice Address - Phone:817-257-6748
Practice Address - Fax:817-257-7944
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX439925163WG0600X, 363LG0600X, 363LA2200X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health