Provider Demographics
NPI:1518942937
Name:BALDWIN, TAMARA A (APNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:A
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:A
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:3263 EATON RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6830
Mailing Address - Country:US
Mailing Address - Phone:920-433-6700
Mailing Address - Fax:
Practice Address - Street 1:301 E SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2241
Practice Address - Country:US
Practice Address - Phone:920-433-0333
Practice Address - Fax:920-437-0533
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2088363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI500028378Medicare Oscar/Certification
WIP71373Medicare UPIN
WI002150274Medicare Oscar/Certification
WIWI1119012Medicare Oscar/Certification
WI430751194Medicare Oscar/Certification
WI100200071Medicare Oscar/Certification
WA000116Medicare Oscar/Certification
WIWI1119012Medicare Oscar/Certification
WI430751194Medicare Oscar/Certification
WI000034Medicare Oscar/Certification