Provider Demographics
NPI:1275248536
Name:BAUGHMAN, KENBERLY KAY (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KENBERLY
Middle Name:KAY
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:985-730-6950
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:106 AVENUE B STE B
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3734
Practice Address - Country:US
Practice Address - Phone:985-730-6950
Practice Address - Fax:985-545-1036
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN126640163WM0705X
LA230549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical