Basic Information
| Provider Information | |||||||||
| NPI: | 1952994188 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GABRIELA M BAIDA MSN, RN LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6566 WIND RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799127349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9153833035 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 DENVER AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799023008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155444000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2021 | ||||||||
| LastUpdateDate: | 05/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | BAIDA | ||||||||
| AuthorizedOfficialFirstName: | GABRIELA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9153295841 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APRN | ||||||||
| NPICertificationDate: | 05/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1568959153 | 05 | TX | MEDICAID |