Basic Information
Provider Information
NPI: 1205893526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAUGHMAN
FirstName: JENNIFER
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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Mailing Information
Address1: 3621 SOUTH STATE STREET
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 EAST MEDICAL CENTER DR
Address2: VON VOIGTLANDER WOMEN'S HOSPITAL
City: ANN ARBOR
State: MI
PostalCode: 481094256
CountryCode: US
TelephoneNumber: 7349364000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2006
LastUpdateDate: 01/11/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X4704234223MIY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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