1417293358 NPI number — MRS. RACHEL BAUM APRN, CNM

Table of content: MRS. RACHEL BAUM APRN, CNM (NPI 1417293358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417293358 NPI number — MRS. RACHEL BAUM APRN, CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUM
Provider First Name:
RACHEL
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHNITZLER
Provider Other First Name:
YAKOVA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1417293358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9401 COLLINS AVE APT 405
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SURFSIDE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33154-2610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-558-3919
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9401 COLLINS AVE APT 405
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SURFSIDE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33154-2610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-558-3919
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  11000442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 175M00000X , with the licence number: MW 250 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MW 250 . This is a "LICENSE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".