Provider Demographics
NPI:1558620229
Name:BAUGHMAN, NICHOLE ANN (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:ANN
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MISTLETOE AVE
Mailing Address - Street 2:
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1320
Mailing Address - Country:US
Mailing Address - Phone:609-425-5274
Mailing Address - Fax:
Practice Address - Street 1:203 MISTLETOE AVE
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1320
Practice Address - Country:US
Practice Address - Phone:609-425-5274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11682500163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant