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General NPI Number Information
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NPI Number | 1881199339
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Entity Type | Individual
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Provider Name | STORMIE S BAXTER M. ED.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 515 W GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-2861
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Country | US
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Telephone | 720-642-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 515 W GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-2861
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Country | US
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Telephone | 720-642-0459
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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 | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 53459
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 22200585
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License Number State | UT
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