MEDICARE: BETH ANNE BAXTER MSN,NP

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	363LA2200X	Adult Health Nurse Practitioner	71000050A	IN

General Provider Information

NPI Number	:	1700965076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH ANNE BAXTER MSN,NP

Provider Business Mailing Address
First Line	:	822 W 1ST ST
Second Line	:	SUITE 1
City	:	BLOOMINGTON
State	:	IN
Zip	:	47403-2384
Country	:	US
Telephone Number	:	812-323-0971
Fax Number	:	812-323-1285

Provider Business Practice Location Address
First Line	:	822 W 1ST ST
Second Line	:	SUITE 1
City	:	BLOOMINGTON
State	:	IN
Zip	:	47403-2384
Country	:	US
Telephone Number	:	812-323-0971
Fax Number	:	812-323-1285

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	04/19/2026

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