NPI Code Details Logo

NPI 1073003018

NPI 1073003018 : CICELY BAUGH HOOTEN PMHNP-BC : MONTGOMERY, AL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1073003018
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CICELY BAUGH HOOTEN PMHNP-BC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/15/2018
-----------------------------------------------------
    Last Update Date     |    10/23/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    445 DEXTER AVE STE 4050 
-----------------------------------------------------
    City                 |    MONTGOMERY
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    36104-3867
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    888-970-9745
-----------------------------------------------------
    Fax                  |    720-674-0156
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    445 DEXTER AVE STE 4050 
-----------------------------------------------------
    City                 |    MONTGOMERY
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    36104-3867
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    888-970-9745
-----------------------------------------------------
    Fax                  |    720-674-0156
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    1089795
-----------------------------------------------------
    License Number State |    AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    C-RXN.0001802-C-NP
-----------------------------------------------------
    License Number State |    CO
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.