Provider Demographics
NPI:1679355549
Name:BAGHAI, CARLEY LINN (DNP, PMHNP-BC, APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARLEY
Middle Name:LINN
Last Name:BAGHAI
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-0508
Mailing Address - Country:US
Mailing Address - Phone:425-306-1392
Mailing Address - Fax:
Practice Address - Street 1:1846 E INNOVATION PARK DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1963
Practice Address - Country:US
Practice Address - Phone:425-306-1392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN209429163W00000X
AZ286953363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse