Provider Demographics
NPI:1790806990
Name:BAUM, SHERYL RONNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:RONNA
Last Name:BAUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14436 HALE RD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33523
Mailing Address - Country:US
Mailing Address - Phone:352-567-1303
Mailing Address - Fax:
Practice Address - Street 1:37944 CHURCH AVE
Practice Address - Street 2:PREMIER COMMUNITY HEALTH GROUP
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525
Practice Address - Country:US
Practice Address - Phone:352-518-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 1339652163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse