Provider Demographics
NPI:1366862260
Name:BALDWIN, SUSAN (RN,CDE)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W SEVENTH ST
Mailing Address - Street 2:FREDERICK REGIONAL HEALTH SYSTEM
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4506
Mailing Address - Country:US
Mailing Address - Phone:240-566-3300
Mailing Address - Fax:240-566-3895
Practice Address - Street 1:5500 BUCKEYSTOWN PIKE
Practice Address - Street 2:FMH WELLNESS CENTER
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8331
Practice Address - Country:US
Practice Address - Phone:240-379-6010
Practice Address - Fax:240-379-6040
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
MDR085828163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No174H00000XOther Service ProvidersHealth Educator