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JANICE BAUCOM N.P.

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1194140319

Individual Registrant:
 JANICE  BAUCOM N.P.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
211 RANCHERA ST NW  LIVE OAK, FL 32064-4866 US
Tel: 386-364-1751  Fax: 386-364-1761

Contact information for business:
23343 NW COUNTY ROAD 236  HIGH SPRINGS, FL 32643-9669 US
Tel: 386-454-0698  Fax: 386-454-0690

Registration Information:
NPI: 1194140319
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
FLARNP2051512
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
FLARNP2051512

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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