Provider Demographics
NPI:1891572707
Name:BAYER, AQUASIA D
Entity Type:Individual
Prefix:
First Name:AQUASIA
Middle Name:D
Last Name:BAYER
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:PO BOX 871762
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70187-1762
Mailing Address - Country:US
Mailing Address - Phone:504-516-4554
Mailing Address - Fax:
Practice Address - Street 1:6856 CINDY PL APT A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2553
Practice Address - Country:US
Practice Address - Phone:504-516-4554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8999852343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)