Provider Demographics
NPI:1740087659
Name:BAUM, ELANA (RN)
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:
Other - Last Name:ACKERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6918 BLUE MESA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6918 BLUE MESA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-6140
Practice Address - Country:US
Practice Address - Phone:845-825-2231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043381163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice