Provider Demographics
NPI:1518023670
Name:BAER, JOHN J (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:BAER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3 LAKEWOODS DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-1227
Mailing Address - Country:US
Mailing Address - Phone:978-771-6363
Mailing Address - Fax:
Practice Address - Street 1:50 PROSPECT ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2841
Practice Address - Country:US
Practice Address - Phone:978-975-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241561367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA430071782OtherRAILROAD MEDICARE
MANA0947OtherBCBS
MANA0947OtherBCBS