Provider Demographics
NPI:1013344589
Name:BAWL, DELICIA C (APRN)
Entity type:Individual
Prefix:
First Name:DELICIA
Middle Name:C
Last Name:BAWL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7601
Mailing Address - Country:US
Mailing Address - Phone:785-827-3551
Mailing Address - Fax:785-827-3576
Practice Address - Street 1:2770 S 9TH ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7601
Practice Address - Country:US
Practice Address - Phone:785-827-3551
Practice Address - Fax:785-827-3576
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76109363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
003719320OtherMEDICARE