Provider Demographics
NPI:1255343349
Name:BALDWIN-DUFOUR, TONI SUE (APRN)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:SUE
Last Name:BALDWIN-DUFOUR
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959203
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-9203
Mailing Address - Country:US
Mailing Address - Phone:618-257-6380
Mailing Address - Fax:618-257-6444
Practice Address - Street 1:4000 N ILLINOIS LN
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1969
Practice Address - Country:US
Practice Address - Phone:618-257-6380
Practice Address - Fax:618-257-6444
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9318582363LF0000X
IL2090280069363L00000X
FLARNP9318582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009087200Medicaid
INS52797Medicare UPIN