Provider Demographics
NPI:1487022802
Name:BAUGHMAN, ELIZABETH ANNE BEATY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH ANNE
Middle Name:BEATY
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BAUGHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1020 DUTCH FORK RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8822
Mailing Address - Country:US
Mailing Address - Phone:803-476-8000
Mailing Address - Fax:
Practice Address - Street 1:1020 DUTCH FORK RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8822
Practice Address - Country:US
Practice Address - Phone:803-476-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC66169163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC66169Medicaid