Provider Demographics
NPI:1275802712
Name:BAUGHMAN, JEANNETTE NICHOLE (LPN)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:NICHOLE
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CARRIE ST
Mailing Address - Street 2:
Mailing Address - City:POWHATAN POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43942-1304
Mailing Address - Country:US
Mailing Address - Phone:740-213-0755
Mailing Address - Fax:
Practice Address - Street 1:104 CARRIE ST
Practice Address - Street 2:
Practice Address - City:POWHATAN POINT
Practice Address - State:OH
Practice Address - Zip Code:43942-1304
Practice Address - Country:US
Practice Address - Phone:740-213-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.145540-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse