Provider Demographics
NPI:1295836393
Name:BAUM, AUDREY ANN (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:ANN
Last Name:BAUM
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 CLIFFS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6014
Mailing Address - Country:US
Mailing Address - Phone:512-263-7271
Mailing Address - Fax:
Practice Address - Street 1:301 SETON PKWY
Practice Address - Street 2:SUITE 405
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8002
Practice Address - Country:US
Practice Address - Phone:512-716-0861
Practice Address - Fax:866-765-3913
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX553757363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health