Provider Demographics
NPI:1265637748
Name:BAUMGARTNER, ELLEN L (RNFA)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:L
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2293
Mailing Address - Country:US
Mailing Address - Phone:541-689-7525
Mailing Address - Fax:
Practice Address - Street 1:643 STERLING DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-2293
Practice Address - Country:US
Practice Address - Phone:541-689-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery