Individual
ANDREA L BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-6863
(417) 820-6868
Mailing address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-6863
(417) 820-6868
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2003012794
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2003012794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176948001
—
AR
05
—
1992995088
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00709665
RAILROAD MEDICARE
—
Enumeration date
07/26/2007
Last updated
10/28/2020
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