Provider Demographics
NPI:1144244393
Name:BAUER, ERIN E (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:BAUER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 WEST PINELOCH AVENUE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6100
Mailing Address - Country:US
Mailing Address - Phone:407-481-7173
Mailing Address - Fax:407-481-7190
Practice Address - Street 1:92 WEST MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-649-9111
Practice Address - Fax:407-481-7190
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9209244163W00000X
LARN097723163W00000X
FLARNP9209422367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307827200Medicaid
FLAA164VMedicare PIN