Provider Demographics
NPI:1740793033
Name:BAXTER, NORDIA KAYE (NP, WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:NORDIA
Middle Name:KAYE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:NP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5145
Mailing Address - Country:US
Mailing Address - Phone:845-659-6334
Mailing Address - Fax:
Practice Address - Street 1:2279 STATE HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1750
Practice Address - Country:US
Practice Address - Phone:800-230-7526
Practice Address - Fax:609-587-0802
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421321363L00000X, 363LW0102X
NJ24NJ00782100363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner