Healthcare Provider Details

I. General information

NPI: 1568615425
Provider Name (Legal Business Name): BRENDA K BALDRIDGE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4578 GALLIA PIKE
FRANKLIN FURNACE OH
45629
US

IV. Provider business mailing address

923 FINDLAY ST
PORTSMOUTH OH
45662-4148
US

V. Phone/Fax

Practice location:
  • Phone: 740-354-6685
  • Fax: 740-354-1662
Mailing address:
  • Phone: 740-354-7702
  • Fax: 740-354-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2008004348
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3006087
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: