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Individual
MISTY LYNN BAGGETT
Active
Individual
MISTY LYNN BAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP133315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368989501
—
TX
05
—
368989502
—
TX
01
—
75-2616977-028
TRICARE
TX
01
—
775135
MEDICARE
TX
01
—
8919MC
BCBS
TX
01
—
P01815482
RAIL ROAD MEDICARE
TX
01
—
P02210499
MEDICARE RAIL ROAD
TX
Enumeration date
02/16/2017
Last updated
05/21/2019
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