Provider Demographics
NPI:1942557723
Name:BAPTIST HEALTH
Entity Type:Organization
Organization Name:BAPTIST HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WAGGONER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:334-358-6501
Mailing Address - Street 1:635 MCQUEEN SMITH RD N
Mailing Address - Street 2:SUITE D
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5660
Mailing Address - Country:US
Mailing Address - Phone:334-358-6501
Mailing Address - Fax:334-358-6521
Practice Address - Street 1:635 MCQUEEN SMITH RD N
Practice Address - Street 2:SUITE D
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5660
Practice Address - Country:US
Practice Address - Phone:334-358-6501
Practice Address - Fax:334-358-6521
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1942391230
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2907261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech