Individual
KATHERINE MICHELE BAUGHMAN GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, FAAO
Contact information
Practice address
8378 N GOVERNMENT WAY, HAYDEN, ID 83835-9258
(208) 209-7100
(208) 209-7911
Mailing address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 770-3814
(208) 691-6327
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
100170
ID
152W00000X
Optometrist
Primary
ODP-100170
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808375600
—
ID
05
—
808375601
—
ID
Enumeration date
02/11/2009
Last updated
08/22/2023
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