Provider Demographics
NPI:1871500678
Name:BAUMEISTER, JEAN M (AUDIOLOGIST)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:BAUMEISTER
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:M
Other - Last Name:RUDKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUDIOLOGIST
Mailing Address - Street 1:2000 Q ST
Mailing Address - Street 2:STE 500
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3610
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:575 S 70TH ST
Practice Address - Street 2:STE 440
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2471
Practice Address - Country:US
Practice Address - Phone:402-484-5500
Practice Address - Fax:402-484-5501
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1742355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024991800Medicaid
NE06637OtherBCBS
NE279207Medicare PIN
Q06636Medicare UPIN