Provider Demographics
NPI:1174484182
Name:BAUGHMAN, JACQUELINE JEAN
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JEAN
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 S HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:IA
Mailing Address - Zip Code:52248-9497
Mailing Address - Country:US
Mailing Address - Phone:319-631-8573
Mailing Address - Fax:319-887-4975
Practice Address - Street 1:400 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4105
Practice Address - Country:US
Practice Address - Phone:319-631-8573
Practice Address - Fax:319-887-4975
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097744163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology