Provider Demographics
NPI:1134608706
Name:BAUDER, FAITH (LVN)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:BAUDER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 HCR 2431
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-5195
Mailing Address - Country:US
Mailing Address - Phone:254-707-7203
Mailing Address - Fax:
Practice Address - Street 1:417 HCR 2431
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-5195
Practice Address - Country:US
Practice Address - Phone:254-707-7203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161422164W00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse