Provider Demographics
NPI:1245565902
Name:BAUSMAN, BARBARA DAWN (RN, BSN, MS,CCRN-CMC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DAWN
Last Name:BAUSMAN
Suffix:
Gender:F
Credentials:RN, BSN, MS,CCRN-CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3773
Mailing Address - Country:US
Mailing Address - Phone:423-239-3783
Mailing Address - Fax:
Practice Address - Street 1:130 W RAVINE RD
Practice Address - Street 2:WELLMONT HOLSTON VALLEY MEDICAL CENTER
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3837
Practice Address - Country:US
Practice Address - Phone:423-224-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN135278163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine