Provider Demographics
NPI:1295972768
Name:BAUMGARDNER, BARBARA (PHD, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:BAUMGARDNER
Suffix:
Gender:F
Credentials:PHD, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N BULLARD AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2518
Mailing Address - Country:US
Mailing Address - Phone:623-262-8915
Mailing Address - Fax:623-536-2008
Practice Address - Street 1:600 N BULLARD AVE STE 10
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2518
Practice Address - Country:US
Practice Address - Phone:623-262-8915
Practice Address - Fax:623-536-2008
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3970103TC0700X
AZAP4352363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical