MEDICARE: CHERYL ANN BALDWIN APRN,BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209006674	IL
2	363LF0000X	Family Nurse Practitioner	AP11150	AZ

General Provider Information

NPI Number	:	1558561241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ANN BALDWIN APRN,BC

Provider Business Mailing Address
First Line	:	8826 E TANQUE VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9607
Country	:	US
Telephone Number	:	520-760-8972
Fax Number	:	520-760-3417

Provider Business Practice Location Address
First Line	:	8826 E TANQUE VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9607
Country	:	US
Telephone Number	:	520-760-8972
Fax Number	:	520-760-3417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	03/31/2020

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