Provider Demographics
NPI:1447250733
Name:BALDWIN, JENNIFER ELIZABETH (DNP, ENP, FNP)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:DNP, ENP, FNP
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:K
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ENP, FNP
Mailing Address - Street 1:5323 HARRY HINES BLVD SLOT 8890
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8890
Mailing Address - Country:US
Mailing Address - Phone:214-822-6929
Mailing Address - Fax:
Practice Address - Street 1:103 AZALEA WAY
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75672-9265
Practice Address - Country:US
Practice Address - Phone:903-387-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP81576Medicare UPIN
TX8C7264Medicare ID - Type UnspecifiedMEDICARE