Provider Demographics
NPI:1295801348
Name:BAILLARGEON, CHARITY B (NP)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:B
Last Name:BAILLARGEON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:495 COOPER RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8780
Mailing Address - Country:US
Mailing Address - Phone:614-865-9200
Mailing Address - Fax:614-865-9800
Practice Address - Street 1:495 COOPER RD
Practice Address - Street 2:SUITE 225
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8780
Practice Address - Country:US
Practice Address - Phone:614-865-9200
Practice Address - Fax:614-865-9800
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09185-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2722342OtherUNITED HEATHCARE PIN
OH000000501937OtherANTHEM PIN