Provider Demographics
NPI:1700174802
Name:BAUGHMAN, KRISTEN ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:BASSETT OR RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 GALLETTI WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5564
Mailing Address - Country:US
Mailing Address - Phone:775-688-3321
Mailing Address - Fax:775-688-3306
Practice Address - Street 1:480 GALLETTI WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431
Practice Address - Country:US
Practice Address - Phone:775-688-3321
Practice Address - Fax:775-688-3306
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1700174802Medicaid