Provider Demographics
NPI:1972534766
Name:BAUMANN, LINDA M (CNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:IVERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:919 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-2172
Mailing Address - Country:US
Mailing Address - Phone:763-389-3344
Mailing Address - Fax:
Practice Address - Street 1:919 NORTHLAND DRIVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-2172
Practice Address - Country:US
Practice Address - Phone:763-389-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN943525500Medicaid
MN943525500Medicaid