Basic Information
| Provider Information | |||||||||
| NPI: | 1568615425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALDRIDGE | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 923 FINDLAY ST | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456624148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403547702 | ||||||||
| FaxNumber: | 7403541662 | ||||||||
| Practice Location | |||||||||
| Address1: | 4578 GALLIA PIKE | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN FURNACE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403546685 | ||||||||
| FaxNumber: | 7403541662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2008 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2008004348 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.