Provider Demographics
NPI:1518624600
Name:BAUER, ROZLYN (NP-C)
Entity Type:Individual
Prefix:
First Name:ROZLYN
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 973
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER MILLS
Mailing Address - State:CA
Mailing Address - Zip Code:96028-0973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43563 CA-299
Practice Address - Street 2:
Practice Address - City:FALL RIVER MILLS
Practice Address - State:CA
Practice Address - Zip Code:96028
Practice Address - Country:US
Practice Address - Phone:530-337-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily