Provider Demographics
NPI:1811455934
Name:BAUGHMAN, NATHAN LYNN (NP)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:LYNN
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 OAK ST
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63565-1180
Mailing Address - Country:US
Mailing Address - Phone:660-947-2411
Mailing Address - Fax:660-947-7024
Practice Address - Street 1:1926 OAK ST
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:MO
Practice Address - Zip Code:63565-1180
Practice Address - Country:US
Practice Address - Phone:660-947-2411
Practice Address - Fax:660-947-7024
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019007619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily