Provider Demographics
NPI:1164421731
Name:THOMAS-BAUER, ELIZABETH L (DNP, FNP-BC, CNE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:THOMAS-BAUER
Suffix:
Gender:F
Credentials:DNP, FNP-BC, CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2019
Mailing Address - Country:US
Mailing Address - Phone:302-563-9666
Mailing Address - Fax:
Practice Address - Street 1:4550 LINDEN HILL RD STE 150
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2909
Practice Address - Country:US
Practice Address - Phone:302-525-4437
Practice Address - Fax:302-397-2964
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000177363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000978242Medicaid
DES61254Medicare UPIN
DE0000978242Medicaid