1326096017 NPI number — TAMARA BAUMANN APRN

Table of content: TAMARA BAUMANN APRN (NPI 1326096017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326096017 NPI number — TAMARA BAUMANN APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUMANN
Provider First Name:
TAMARA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1326096017
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3325 RESEARCH WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARSON CITY
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89706-7913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-888-6610
Provider Business Mailing Address Fax Number:
775-888-4904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3325 RESEARCH WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89706-7913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-887-5140
Provider Business Practice Location Address Fax Number:
775-884-3618
Provider Enumeration Date:
05/04/2006

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: 163W00000X , with the licence number:  RN22645 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: APRN000615 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , with the licence number: APRN000615 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: APRN000615 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: APRN000615 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12077072 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1326096017 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".