Individual
BLAIR ANDERSON BAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 676-4542
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71008293A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008293A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71008293A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001217774
ANTHEM PTAN
IN
05
—
300019980
—
IN
01
—
P02195074
RAILROAD PTAN
IN
Enumeration date
08/31/2018
Last updated
11/06/2024
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