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LOUELLA BAUMAN FNP-BC

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

Registrant NPI Number: 1699166199

Individual Registrant:
 LOUELLA  BAUMAN FNP-BC
Gender: F
Sole Proprietor

Location and contact information for practice:
19251 E OASIS DR  BLACK CANYON CITY, AZ 85324-8878 US
Tel: 623-374-0200  Fax: 623-374-5576

Contact information for business:
19251 E OASIS DR  BLACK CANYON CITY, AZ 85324-8878 US
Tel: 623-374-0200  Fax: 623-374-5576

Registration Information:
NPI: 1699166199
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AZTAP7624
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
AZAP7624

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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