Provider Demographics
NPI:1821377375
Name:BAUMANN, LAUREN DIANE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:DIANE
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1300 EGG HARBOR RD., SUITE 108
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-1277
Mailing Address - Country:US
Mailing Address - Phone:920-746-0410
Mailing Address - Fax:920-746-0244
Practice Address - Street 1:1300 EGG HARBOR RD., SUITE 108
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-1277
Practice Address - Country:US
Practice Address - Phone:920-746-0410
Practice Address - Fax:920-746-0244
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1261-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer