MEDICARE: MS. SHARON M BALDWIN CNS

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	CNS25A	ID
2	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	2006504405	UT
3	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	2006508900	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811947526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON M BALDWIN CNS

Provider Business Mailing Address
First Line	:	13211 N ANDYS GULCH RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83714-9427
Country	:	US
Telephone Number	:	208-841-6541
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 16TH AVE N
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83687-4058
Country	:	US
Telephone Number	:	208-467-7654
Fax Number	:	208-318-1391

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/31/2013

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