MEDICARE: MS. ANGEL DANIELLE BALDWIN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	138450-030	WI

General Provider Information

NPI Number	:	1265693329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGEL DANIELLE BALDWIN RN

Provider Business Mailing Address
First Line	:	5475 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-4617
Country	:	US
Telephone Number	:	414-527-9412
Fax Number	:

Provider Business Practice Location Address
First Line	:	5475 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-4617
Country	:	US
Telephone Number	:	414-527-9412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	06/21/2008

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