Healthcare Provider Details

I. General information

NPI: 1659691939
Provider Name (Legal Business Name): DEVEN BAUGHN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S FAYETTE ST
WASHINGTON COURT HOUSE OH
43160-2235
US

IV. Provider business mailing address

317 S FAYETTE ST
WASHINGTON COURT HOUSE OH
43160-2235
US

V. Phone/Fax

Practice location:
  • Phone: 740-335-5910
  • Fax:
Mailing address:
  • Phone: 740-335-5910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN357982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: