Provider Demographics
NPI:1740931567
Name:BALDWIN, ANDREA JEAN (RN BSN CCM)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:RN BSN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W NORMAL DR
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-1535
Mailing Address - Country:US
Mailing Address - Phone:785-691-5531
Mailing Address - Fax:
Practice Address - Street 1:401 W NORMAL DR
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-1535
Practice Address - Country:US
Practice Address - Phone:785-691-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60968695163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN60968695OtherWA NURSING LICENSE