Provider Demographics
NPI:1184779480
Name:BAXTER, MICHELE COMTE (CRNA)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:COMTE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5582
Mailing Address - Country:US
Mailing Address - Phone:240-620-1268
Mailing Address - Fax:
Practice Address - Street 1:874 FOX DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-8613
Practice Address - Country:US
Practice Address - Phone:540-662-8336
Practice Address - Fax:540-662-8593
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD38049207L00000X
MDR110804367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty