Provider Demographics
NPI:1295282580
Name:BAUMANN-GOLDEN, SARA M (LPN)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:M
Last Name:BAUMANN-GOLDEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-2512
Mailing Address - Country:US
Mailing Address - Phone:920-254-6312
Mailing Address - Fax:
Practice Address - Street 1:1931 N 12TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-2512
Practice Address - Country:US
Practice Address - Phone:920-254-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI321089-31374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide