Healthcare Provider Details

I. General information

NPI: 1144134248
Provider Name (Legal Business Name): CORALEA BALDWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORA BALDWIN MSW

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 REILY RD
LINCOLN ND
58504-9323
US

IV. Provider business mailing address

4668 STURGIS RD UNIT 1
RAPID CITY SD
57702-0402
US

V. Phone/Fax

Practice location:
  • Phone: 605-280-8657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: