Healthcare Provider Details

I. General information

NPI: 1295247930
Provider Name (Legal Business Name): BAINDU GBOW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 LANCASTER PIKE
READING PA
19607-2375
US

IV. Provider business mailing address

2395 LANCASTER PIKE
READING PA
19607-2375
US

V. Phone/Fax

Practice location:
  • Phone: 610-839-8752
  • Fax: 484-339-5685
Mailing address:
  • Phone: 610-839-8752
  • Fax: 484-339-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP036359
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP026329
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: