Provider Demographics
NPI:1740703263
Name:BAUMAN, ERIN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2680 S COMO RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-3430
Mailing Address - Country:US
Mailing Address - Phone:815-790-4420
Mailing Address - Fax:
Practice Address - Street 1:N2680 S COMO RD
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-3430
Practice Address - Country:US
Practice Address - Phone:815-790-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7841-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner