Provider Demographics
NPI:1558993048
Name:BAUMEISTER, JAMIE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:BAUMEISTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-2402
Mailing Address - Country:US
Mailing Address - Phone:317-588-7111
Mailing Address - Fax:
Practice Address - Street 1:2612 WYOMING ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-2402
Practice Address - Country:US
Practice Address - Phone:317-588-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018033035174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist