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General NPI Number Information
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NPI Number | 1558754283
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Entity Type | Individual
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Provider Name | JAKITA BALDWIN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 14555 W NATIONAL AVE
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City | NEW BERLIN
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State | WI
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Zip | 53151-4494
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Country | US
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Telephone | 844-284-0381
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 125.069913
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 86501-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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