Provider Demographics
NPI:1164479234
Name:BAUMANN, MEGHAN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:355 E ASH AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-6136
Mailing Address - Country:US
Mailing Address - Phone:217-450-9826
Mailing Address - Fax:217-717-2346
Practice Address - Street 1:355 E ASH AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-6136
Practice Address - Country:US
Practice Address - Phone:217-450-9826
Practice Address - Fax:217-717-2346
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-002182363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical