Healthcare Provider Details
I. General information
NPI: 1255440186
Provider Name (Legal Business Name): SARA MARIE BALDWIN PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3024 NEW BERN AVE NEONATOLOGY DEPT.
RALEIGH NC
27610-1247
US
IV. Provider business mailing address
10113 SAN REMO PL STE 300
WAKE FOREST NC
27587-1622
US
V. Phone/Fax
- Phone: 919-350-8545
- Fax: 919-350-8146
- Phone: 919-244-0311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 300263 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 172839 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: