Provider Demographics
NPI:1881235158
Name:BAGINSKI, KAYLIN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLIN
Middle Name:MARIE
Last Name:BAGINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLIN
Other - Middle Name:MARIE
Other - Last Name:MARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2406 NEWKIRK LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8887
Mailing Address - Country:US
Mailing Address - Phone:814-602-2322
Mailing Address - Fax:
Practice Address - Street 1:7450 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9642
Practice Address - Country:US
Practice Address - Phone:614-566-8149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006177RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid