Provider Demographics
NPI:1285474965
Name:BALDWIN, MELANIE WRIGHT (FNP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:WRIGHT
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2973 WHISTLER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6770
Mailing Address - Country:US
Mailing Address - Phone:770-630-1788
Mailing Address - Fax:
Practice Address - Street 1:751 OLD RICHARDSON HWY STE 101
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7802
Practice Address - Country:US
Practice Address - Phone:907-328-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK225294163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice