Doctor Name: | JODY L BAUER |
NPI Number: | 1003904061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP30004830 |
Business Practice Address: | 2979 Squalicum Pkwy Suite 301 Bellingham, WA - 982251811 |
Business Phone Number: | 3607341420 |
Business Fax Number: | 3607331659 |
Mailing Address: | 2979 Squalicum Pkwy, Suite 301 BELLINGHAM |
State: | WA |
Postal Code: | 982251811 |
Phone Number: | 3607341420 |
Fax Number: | 3607331659 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 06/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP30004830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |