Healthcare Provider Details

I. General information

NPI: 1376307801
Provider Name (Legal Business Name): AMANDA NASH BALDWIN NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CURTIS ELLIS DR
ROCKY MOUNT NC
27804-2237
US

IV. Provider business mailing address

6921 WELLSFORD LN
COLLEGE GROVE TN
37046-1431
US

V. Phone/Fax

Practice location:
  • Phone: 252-962-8000
  • Fax: 252-962-8188
Mailing address:
  • Phone: 615-484-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN0000034562
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5023534
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: