Healthcare Provider Details

I. General information

NPI: 1255722039
Provider Name (Legal Business Name): JOHN BALDES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2015
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BOWEN CT
CARTERSVILLE GA
30120-2493
US

IV. Provider business mailing address

5 BOWEN CT
CARTERSVILLE GA
30120-2493
US

V. Phone/Fax

Practice location:
  • Phone: 470-227-7570
  • Fax: 678-719-8386
Mailing address:
  • Phone: 470-227-7570
  • Fax: 678-719-8386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN241341
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN241341
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: