Provider Demographics
NPI:1841737624
Name:BALDWIN, NATALIE ANN (PMHNP)
Entity Type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:ANN
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PINE WEST PLZ STE 110
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5531
Mailing Address - Country:US
Mailing Address - Phone:518-362-7818
Mailing Address - Fax:
Practice Address - Street 1:1 PINE WEST PLZ STE 110
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5531
Practice Address - Country:US
Practice Address - Phone:518-362-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22668351163W00000X
NYF402132363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04785746Medicaid