1841251626 NPI number — MS. KRISTIN LEIGH BALDWIN M.S.

Table of content: MS. KRISTIN LEIGH BALDWIN M.S. (NPI 1841251626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841251626 NPI number — MS. KRISTIN LEIGH BALDWIN M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BALDWIN
Provider First Name:
KRISTIN
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
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:
1841251626
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4301 W MARKHAM ST
Provider Second Line Business Mailing Address:
SLOT 506
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72205-7101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-296-1732
Provider Business Mailing Address Fax Number:
501-296-1701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4301 W MARKHAM ST
Provider Second Line Business Practice Location Address:
SLOT 506
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205-7101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-296-1732
Provider Business Practice Location Address Fax Number:
501-296-1701
Provider Enumeration Date:
03/31/2006

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: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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