MEDICARE: DR. JANET E. BAUMANN III PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY0402	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558344317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET E. BAUMANN III PH.D

Provider Business Mailing Address
First Line	:	2030 E FLAMINGO RD
Second Line	:	SUITE 261
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0831
Country	:	US
Telephone Number	:	702-212-9800
Fax Number	:	702-313-6748

Provider Business Practice Location Address
First Line	:	2030 E FLAMINGO RD
Second Line	:	SUITE 261
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0818
Country	:	US
Telephone Number	:	702-212-9800
Fax Number	:	702-313-6748

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	05/25/2016

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