Provider Demographics
NPI:1821610601
Name:MICHELE BAUER, CNM, LLC
Entity Type:Organization
Organization Name:MICHELE BAUER, CNM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:401-424-5599
Mailing Address - Street 1:2 COOKE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2006
Mailing Address - Country:US
Mailing Address - Phone:401-424-5599
Mailing Address - Fax:
Practice Address - Street 1:577 BROAD ST
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-2837
Practice Address - Country:US
Practice Address - Phone:401-424-5599
Practice Address - Fax:401-246-8271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Single Specialty