Provider Demographics
NPI:1871088757
Name:BALDWIN, LARA (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 W SUNSET BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2241
Mailing Address - Country:US
Mailing Address - Phone:646-650-5337
Mailing Address - Fax:
Practice Address - Street 1:3921 W SUNSET BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2241
Practice Address - Country:US
Practice Address - Phone:646-650-5337
Practice Address - Fax:646-871-6820
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH067880-23363LW0102X, 367A00000X
CANMW236245367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health