Provider Demographics
NPI:1508142795
Name:BAYNHAM, CARMEN GAIL (APRN)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:GAIL
Last Name:BAYNHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:GAIL
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2700 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1242
Mailing Address - Country:US
Mailing Address - Phone:620-663-8484
Mailing Address - Fax:
Practice Address - Street 1:2700 E 30TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1242
Practice Address - Country:US
Practice Address - Phone:620-663-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5345099041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200964770BMedicaid
KS200964770BMedicaid