Melissa Lynn Baughman
Individual provider Active NPI Family Nurse Practitioner · Fort Wayne, IN
NPI 1891936712 · NPPES record last updated Dec 26, 2012
Key facts
- NPI
- 1891936712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71002884A (IN)
- Practice address
- 11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845-1730 - Phone
- (260) 460-3100
- NPI assigned
- Mar 23, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71002884A | IN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71002884A | IN | Yes |
Addresses
Primary practice location
11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845-1730
Mailing address
11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845-1730
Phone (260) 460-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201077920 | Medicaid | IN |
Other providers in Fort Wayne, IN
- Mary Lauren Bauer
- Melinda Bauer
- Paul Mitchell Bauer
- Sara L Bauer
- Jacqueline Baughman
- Blake Bauman
- Laramie G Bauman
- Tiffany J. Bauman
- Delaney Baumann
- Kelly Ann Baumgarden
All providers in Fort Wayne, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.