Provider Demographics
NPI:1588813430
Name:BAUMHOVER, RENEE BETH (ARNP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:BETH
Last Name:BAUMHOVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:BETH
Other - Last Name:LANGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1414
Mailing Address - Country:US
Mailing Address - Phone:515-243-8842
Mailing Address - Fax:515-282-9806
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:SUITE 405
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1414
Practice Address - Country:US
Practice Address - Phone:515-243-8842
Practice Address - Fax:515-282-9806
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF-103711363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1588813430Medicaid
IA71926045Medicare PIN