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NPI Code Detail

MEDICARE: REBECCA ANN BALDWIN AGPCNP-C

MEDICARE: REBECCA ANN BALDWIN AGPCNP-C
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
1363LP2300XPrimary Care Nurse Practitioner95013822CA

General Provider Information

NPI Number : 1538797022
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN BALDWIN AGPCNP-C
Provider Business Mailing Address
First Line : 639 VALLEY VIEW DR
Second Line :
City : REDLANDS
State : CA
Zip : 92373-7357
Country : US
Telephone Number : 714-343-9576
Fax Number :
Provider Business Practice Location Address
First Line : 12047 4TH ST
Second Line :
City : YUCAIPA
State : CA
Zip : 92399-2735
Country : US
Telephone Number : 909-797-5101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 03/30/2020

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