Provider Demographics
NPI:1962894568
Name:BALDWIN, GAIL (RN CCRN WCC)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:RN CCRN WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 TOMAHAWK CT
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-1003
Mailing Address - Country:US
Mailing Address - Phone:417-839-7637
Mailing Address - Fax:
Practice Address - Street 1:761 TOMAHAWK CT
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-1003
Practice Address - Country:US
Practice Address - Phone:417-839-7637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120087163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care