1740793033 NPI number — MS. NORDIA KAYE BAXTER NP, WHNP-BC

Table of content: MS. NORDIA KAYE BAXTER NP, WHNP-BC (NPI 1740793033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740793033 NPI number — MS. NORDIA KAYE BAXTER NP, WHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAXTER
Provider First Name:
NORDIA
Provider Middle Name:
KAYE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP, WHNP-BC
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:
1740793033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 WOOD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING VALLEY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10977-5145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-659-6334
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2279 STATE HIGHWAY 33
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-1750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-230-7526
Provider Business Practice Location Address Fax Number:
609-587-0802
Provider Enumeration Date:
11/09/2017

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: 363L00000X , with the licence number:  421321 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 421321 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 24NJ00782100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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