Provider Demographics
NPI:1780822114
Name:BAYER, MEGAN RAE (RN BSN IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:BAYER
Suffix:
Gender:F
Credentials:RN BSN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 N ARMOUR ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-1329
Mailing Address - Country:US
Mailing Address - Phone:316-648-2768
Mailing Address - Fax:
Practice Address - Street 1:1019 N ARMOUR ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1329
Practice Address - Country:US
Practice Address - Phone:316-648-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-93142-032163W00000X
KS108-86036163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse