Provider Demographics
NPI:1548419476
Name:BAUNHOFER, MAIREN L (NP)
Entity Type:Individual
Prefix:
First Name:MAIREN
Middle Name:L
Last Name:BAUNHOFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MAIREN
Other - Middle Name:L
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:30265 COMMERCE DR
Mailing Address - Street 2:UNIT 207
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3727
Mailing Address - Country:US
Mailing Address - Phone:410-912-6104
Mailing Address - Fax:
Practice Address - Street 1:11101 CATHAGE RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-912-6104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR169373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily