Provider Demographics
NPI:1508884867
Name:BALDWIN, ANGELA FAYE (CRNA, MSN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:FAYE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:CRNA, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 HIGHLAND WOODS DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9409
Mailing Address - Country:US
Mailing Address - Phone:727-599-1942
Mailing Address - Fax:
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-584-6555
Practice Address - Fax:727-581-8507
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN071164367500000X
FLARNP3375942367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306659200Medicaid
FLG3540OtherBCBS
FLG3540OtherBCBS