Doctor Name: | LYNDA SUE BAUM |
NPI Number: | 1063504025 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, APRN |
License Number: | 180643-4405 |
Business Practice Address: | 881 W State Rd Ste 140-429 Pleasant Grove, UT - 840622131 |
Business Phone Number: | 8014229729 |
Business Fax Number: | 8013677678 |
Mailing Address: | 10938 N 5870 W, HIGHLAND |
State: | UT |
Postal Code: | 840039487 |
Phone Number: | 8017568917 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 04/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0809X |
License Number: | 180643-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |