Provider Demographics
NPI:1033424684
Name:BAUMGARTNER, ANNE MARIE (RN, MSN,ARNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:RN, MSN,ARNP-BC
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:BOUDREAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:401 KEISLER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7084
Mailing Address - Country:US
Mailing Address - Phone:919-439-6120
Mailing Address - Fax:919-246-4420
Practice Address - Street 1:401 KEISLER DR STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7084
Practice Address - Country:US
Practice Address - Phone:919-439-6120
Practice Address - Fax:919-246-4420
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6560P363LP0808X
NC5004940363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400024414Medicare PIN
NC2595023Medicare PIN