Provider Demographics
NPI:1750343687
Name:BAYER, MONICA A (RNC, OGNP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:BAYER
Suffix:
Gender:F
Credentials:RNC, OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 DODD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2160
Mailing Address - Country:US
Mailing Address - Phone:651-241-7733
Mailing Address - Fax:651-241-0258
Practice Address - Street 1:2805 DODD RD STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2160
Practice Address - Country:US
Practice Address - Phone:651-241-7733
Practice Address - Fax:651-241-0258
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1186509363L00000X
MN189363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN213525600Medicaid
MN978824700Medicaid