Provider Demographics
NPI:1174057376
Name:BAUGH, HANNAH
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:BAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-778-8264
Mailing Address - Fax:501-778-7360
Practice Address - Street 1:819 W CARPENTER ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3349
Practice Address - Country:US
Practice Address - Phone:501-778-8264
Practice Address - Fax:501-778-7360
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR095319163W00000X
ARA005206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse