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NPI Code Detail

MEDICARE: LISA ANN BALDWIN FNP

MEDICARE: LISA ANN BALDWIN FNP
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
1363LF0000XFamily Nurse Practitioner11715CA

General Provider Information

NPI Number : 1619182656
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN BALDWIN FNP
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4910 AIRPORT PLAZA DR STE 210
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1377
Country : US
Telephone Number : 562-421-3727
Fax Number : 562-420-8948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2007
Last Update Date : 11/14/2025

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