Healthcare Provider Details

I. General information

NPI: 1609798347
Provider Name (Legal Business Name): MADELYN ROSE BAUGHN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2451
US

IV. Provider business mailing address

2508 PALMER AVE
NEW ORLEANS LA
70118-6320
US

V. Phone/Fax

Practice location:
  • Phone: 150-484-2300
  • Fax:
Mailing address:
  • Phone: 603-969-3696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number247881
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: