1689632200 NPI number — LINDA K BAXTER CNM MS

Table of content: LINDA K BAXTER CNM MS (NPI 1689632200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689632200 NPI number — LINDA K BAXTER CNM MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAXTER
Provider First Name:
LINDA
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689632200
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
725 NORTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-447-2752
Provider Business Mailing Address Fax Number:
413-496-6836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
780 MAIN ST
Provider Second Line Business Practice Location Address:
BARRINGTON OBGYN
Provider Business Practice Location Address City Name:
GREAT BARRINGTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-528-1470
Provider Business Practice Location Address Fax Number:
413-528-3167
Provider Enumeration Date:
05/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  183910 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0390879 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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