Lara Mitchell Bauducco, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15250200 Issued in NJ

Practice address

100 Ashurst LN Ste 115
Mount Holly, NJ 08060-1202

Phone

(609) 853-5494

NPI assigned

Jan 27, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1750194502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 SHELLY LN",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343119",
            "telephone_number": "267-242-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ASHURST LN STE 115",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080601202",
            "telephone_number": "609-853-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL BAUDUCCO",
        "first_name": "LARA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15250200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mending Hands Surgical Assisting, LLC
• Ruth Menezes-Allman
• Rashida Mengi, MD
• Eric T. Miller, CRNA
• Kerstin Mingee, MS, LAC
• Amanda Lynn Mitchell, APN, PMHNP-BC
• Jacqueline Mitchell
• Sanaa Saher Mithaiwala, D.O.
• Mobile Physician Group, PC
• Sergey Moldavskiy, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Mount Holly, NJ
• Providers in Mount Holly, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.