Provider Demographics
NPI:1851683486
Name:BAUMGARD, ROBYN DE AN
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:DE AN
Last Name:BAUMGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4834
Mailing Address - Country:US
Mailing Address - Phone:402-371-2340
Mailing Address - Fax:402-371-9199
Practice Address - Street 1:1300 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4834
Practice Address - Country:US
Practice Address - Phone:402-371-2340
Practice Address - Fax:402-371-9199
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5239183500000X
NE14945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist