Provider Demographics
NPI:1467289900
Name:BAYER, ANTONETTE CELINE (RN)
Entity type:Individual
Prefix:
First Name:ANTONETTE
Middle Name:CELINE
Last Name:BAYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANTONETTE
Other - Middle Name:CELINE
Other - Last Name:ILLIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3932 SHILOH AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2209
Mailing Address - Country:US
Mailing Address - Phone:410-375-2989
Mailing Address - Fax:
Practice Address - Street 1:3525 RESOURSE DRIVE
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133
Practice Address - Country:US
Practice Address - Phone:410-599-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196954163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn