Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 11007932 | FL |
NPI | 1033732276 |
---|---|
Provider Name | Cynthia Michelle Baxter |
First Address | Holly Hill, FL 32117-4968 |
Second Address | Oxford, FL 34484-3558 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2020 |
Last Update Date | 06/07/2020 |