Provider Demographics
NPI:1386270627
Name:BALDWIN, BENJAMIN (MSN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 LEE ROAD 236
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-8835
Mailing Address - Country:US
Mailing Address - Phone:706-570-4680
Mailing Address - Fax:
Practice Address - Street 1:7901 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-1723
Practice Address - Country:US
Practice Address - Phone:706-221-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN239889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily