Healthcare Provider Details

I. General information

NPI: 1306129697
Provider Name (Legal Business Name): JAMIE E BALDWIN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE E CARDNER PA

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S PEORIA ST #100
AURORA CO
80014-5476
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 303-306-4321
  • Fax: 720-524-1551
Mailing address:
  • Phone: 970-624-4036
  • Fax: 970-490-4378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-1125
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3601
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: