Provider Demographics
NPI:1689632200
Name:BAXTER, LINDA K (CNM MS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:BAXTER
Suffix:
Gender:F
Credentials:CNM MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-447-2752
Mailing Address - Fax:413-496-6836
Practice Address - Street 1:780 MAIN ST
Practice Address - Street 2:BARRINGTON OBGYN
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-528-1470
Practice Address - Fax:413-528-3167
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183910367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0390879Medicaid
MA0390879Medicaid
CN0106Medicare ID - Type Unspecified