Healthcare Provider Details

I. General information

NPI: 1801646138
Provider Name (Legal Business Name): CARMEN BALDWIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN SHAMOON

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4875 HIGBEE AVE NW
CANTON OH
44718-2566
US

IV. Provider business mailing address

4875 HIGBEE AVE NW
CANTON OH
44718-2566
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-3345
  • Fax:
Mailing address:
  • Phone: 847-722-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0035981
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: