Provider Demographics
NPI:1447842844
Name:BALDWIN, LISA KAYE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KAYE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 TURK RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49267-8509
Mailing Address - Country:US
Mailing Address - Phone:734-652-7411
Mailing Address - Fax:
Practice Address - Street 1:7330 TURK RD
Practice Address - Street 2:
Practice Address - City:OTTAWA LAKE
Practice Address - State:MI
Practice Address - Zip Code:49267-8509
Practice Address - Country:US
Practice Address - Phone:734-652-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay