Provider Demographics
NPI:1194606566
Name:BAUDIN, MYRNA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:
Last Name:BAUDIN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 SW 160TH AVE APT 200
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5738
Mailing Address - Country:US
Mailing Address - Phone:786-317-3430
Mailing Address - Fax:
Practice Address - Street 1:4405 SW 160TH AVE APT 200
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5738
Practice Address - Country:US
Practice Address - Phone:786-317-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9196461163WC1500X
FL11042330363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty