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Contact Information

DONAVON BALDRIDGE, APRN
19600 E ROSS ST
TAHLEQUAH, OK74464-0545
 Phone: 539-234-1000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for DONAVON BALDRIDGE · (Male)

NPI # 1134800964
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 07/25/2023
Last updated 10/17/2025 - About 8 months ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 201015
  • OK Medicaid 201188720A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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