Provider Demographics
NPI:1669994240
Name:BAUER, MICHELLE (RN BSN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N ERIE ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5317
Mailing Address - Country:US
Mailing Address - Phone:419-213-4138
Mailing Address - Fax:419-213-4196
Practice Address - Street 1:635 N ERIE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5317
Practice Address - Country:US
Practice Address - Phone:416-213-4138
Practice Address - Fax:419-213-4196
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN192702163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse