Healthcare Provider Details

I. General information

NPI: 1164421731
Provider Name (Legal Business Name): ELIZABETH L THOMAS-BAUER DNP, FNP-BC, CNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PHILADELPHIA PIKE
CLAYMONT DE
19703-2431
US

IV. Provider business mailing address

120 SUNSET DR
WILMINGTON DE
19809-2019
US

V. Phone/Fax

Practice location:
  • Phone: 302-317-1531
  • Fax: 302-291-4986
Mailing address:
  • Phone: 302-563-9666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000177
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: