Barbara Baggstrom, CPNP

Individual provider Active NPI Nurse Practitioner · Randolph, NJ

NPI 1104894989 · NPPES record last updated Jun 5, 2012

Key facts

NPI
1104894989
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
26NJ00086700 (NJ)
Practice address
765 Route 10 E
Ste 203
Randolph, NJ 07869-1925
Phone
(973) 659-9991
Fax
(973) 659-9632
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
College Plaza Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00086700 NJ Yes

Addresses

Primary practice location

765 Route 10 E
Ste 203
Randolph, NJ 07869-1925

Mailing address

765 Route 10 E
Ste 203
Randolph, NJ 07869-1925
Phone (973) 659-9991

Other providers in Randolph, NJ

All providers in Randolph, NJ · Nurse Practitioner in New Jersey

Sources for this page

Verify at the official NPI Registry.