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General NPI Number Information
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NPI Number | 1487103594
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Entity Type | Individual
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Provider Name | GREGORY DEAN BAISDEN ARNP
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Gender | Male
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 7050 GALL BLVD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-1347
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Country | US
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Telephone | 863-559-7161
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 RUSHING RD
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City | LAKELAND
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State | FL
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Zip | 33810-0738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | ARNP9333183
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9333183
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License Number State | FL
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