Healthcare Provider Details

I. General information

NPI: 1730047929
Provider Name (Legal Business Name): HAYLEY BALDWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1497 NASHVILLE ST
RUSSELLVILLE KY
42276-8850
US

IV. Provider business mailing address

3365 STAGECOACH RD
HANSON KY
42413-9627
US

V. Phone/Fax

Practice location:
  • Phone: 270-726-9568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4052048
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: