JACQUELYN THERESA BAUCOM — OIG Excluded Provider (MONROE, NC, 1128b4)
JACQUELYN THERESA BAUCOM — OIG Excluded Provider (MONROE, NC, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: JACQUELYN THERESA BAUCOM; Type: Individual; Provider category: IND- LIC HC SERV PRO.
| Name | JACQUELYN THERESA BAUCOM |
|---|---|
| Type | Individual |
| Provider category | IND- LIC HC SERV PRO |
| Specialty | NURSE/NURSES AIDE |
| City | MONROE |
| State | NC |
| ZIP | 28112 |
| Exclusion authority | 1128b4 |
| Exclusion reason | License revocation, suspension, or surrender |
| Exclusion date | 2012-07-19 |
| Source | HHS-OIG LEIE |
$1499/mo
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