Healthcare Provider Details

I. General information

NPI: 1417776287
Provider Name (Legal Business Name): MICHAELA BALDWIN CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4386 LINDELL BLVD STE 104
SAINT LOUIS MO
63108-2702
US

IV. Provider business mailing address

4386 LINDELL BLVD FL 1
SAINT LOUIS MO
63108-2702
US

V. Phone/Fax

Practice location:
  • Phone: 314-399-9365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number295000011
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCPM24100578
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: