Provider Demographics
NPI:1710973953
Name:BAUGHMAN-GROSS, CATHY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:BAUGHMAN-GROSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11256 NORMANTON CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2904
Mailing Address - Country:US
Mailing Address - Phone:858-271-7762
Mailing Address - Fax:
Practice Address - Street 1:7500 HARDY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92182-0001
Practice Address - Country:US
Practice Address - Phone:619-594-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA286434OtherRN LICENSE
CANP8350OtherFURNISHING NUMBER
CANP8350OtherFURNISHING NUMBER