Healthcare Provider Details

I. General information

NPI: 1427353283
Provider Name (Legal Business Name): SELENA LEE BALDWIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SELENA LEE SMITH

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 HILLCREST RD # TD
MOBILE AL
36695-3841
US

IV. Provider business mailing address

6021 COOPER DR
MOBILE AL
36693-3072
US

V. Phone/Fax

Practice location:
  • Phone: 251-459-6200
  • Fax:
Mailing address:
  • Phone: 601-394-9098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1-170904
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR865284
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-170904
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: