Provider Demographics
NPI:1942416094
Name:BAUDOIN, ELAINE LOIS (DC)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:LOIS
Last Name:BAUDOIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:L
Other - Last Name:BAUDOIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3540 RED WING BLVD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3948
Mailing Address - Country:US
Mailing Address - Phone:651-437-9246
Mailing Address - Fax:
Practice Address - Street 1:3540 RED WING BLVD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3948
Practice Address - Country:US
Practice Address - Phone:651-437-9246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3K906OtherBA BCBS
MN3K906OtherBA BCBS