Provider Demographics
NPI:1013434653
Name:BALDRIDGE, LORI (RN)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:BALDRIDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6437 FAIRWAY AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-1426
Mailing Address - Country:US
Mailing Address - Phone:971-304-7494
Mailing Address - Fax:971-332-5926
Practice Address - Street 1:6437 FAIRWAY AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-1426
Practice Address - Country:US
Practice Address - Phone:971-304-7494
Practice Address - Fax:971-332-5926
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2021-12-16
Deactivation Date:2018-05-05
Deactivation Code:
Reactivation Date:2021-10-26
Provider Licenses
StateLicense IDTaxonomies
OR200642569RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health