Provider Demographics
NPI:1801646138
Name:BALDWIN, CARMEN (NP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:SHAMOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4875 HIGBEE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2566
Mailing Address - Country:US
Mailing Address - Phone:847-722-7054
Mailing Address - Fax:
Practice Address - Street 1:4875 HIGBEE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2566
Practice Address - Country:US
Practice Address - Phone:330-492-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily