Provider Demographics
NPI:1568615425
Name:BALDRIDGE, BRENDA K (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:K
Last Name:BALDRIDGE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 FINDLAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4148
Mailing Address - Country:US
Mailing Address - Phone:740-354-7702
Mailing Address - Fax:740-354-1662
Practice Address - Street 1:4578 GALLIA PIKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN FURNACE
Practice Address - State:OH
Practice Address - Zip Code:45629
Practice Address - Country:US
Practice Address - Phone:740-354-6685
Practice Address - Fax:740-354-1662
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2008004348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily