Healthcare Provider Details

I. General information

NPI: 1730740358
Provider Name (Legal Business Name): LAUREN BAUGHMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CELEBRATION DR
ROCHESTER NY
14620-2664
US

IV. Provider business mailing address

40 CELEBRATION DR
ROCHESTER NY
14620-2664
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-7546
  • Fax:
Mailing address:
  • Phone: 585-275-7546
  • Fax: 585-461-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number299853
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number344627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: