Provider Demographics
NPI:1821545518
Name:SARA M BAUMANN-GOLDEN
Entity Type:Organization
Organization Name:SARA M BAUMANN-GOLDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUMANN-GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:920-254-6312
Mailing Address - Street 1:1931 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-2512
Mailing Address - Country:US
Mailing Address - Phone:920-254-6312
Mailing Address - Fax:
Practice Address - Street 1:1931 N 12TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-2512
Practice Address - Country:US
Practice Address - Phone:920-254-6312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI321089-31251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care