Provider Demographics
NPI:1992150551
Name:ALLBAUGH, JANET (CFNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:ALLBAUGH
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PRINCE WILLIAM RD
Mailing Address - Street 2:STE A
Mailing Address - City:DELPHI
Mailing Address - State:IN
Mailing Address - Zip Code:46923-1759
Mailing Address - Country:US
Mailing Address - Phone:765-564-3016
Mailing Address - Fax:765-564-2608
Practice Address - Street 1:901 PRINCE WILLIAM RD STE A
Practice Address - Street 2:
Practice Address - City:DELPHI
Practice Address - State:IN
Practice Address - Zip Code:46923-1759
Practice Address - Country:US
Practice Address - Phone:765-564-3016
Practice Address - Fax:765-564-2608
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006441A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201389620Medicaid
INPENDINGOtherANTHEM PROVIDER NUMBER
INPENDINGMedicare PIN