Healthcare Provider Details

I. General information

NPI: 1801174404
Provider Name (Legal Business Name): KATHRYN BAUK CAMPBELL RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN MARIE BAUK RN, CPNP

II. Dates (important events)

Enumeration Date: 07/30/2011
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WHEELER ST
SAVANNAH GA
31405-5700
US

IV. Provider business mailing address

2 WHEELER ST
SAVANNAH GA
31405-5700
US

V. Phone/Fax

Practice location:
  • Phone: 912-353-7744
  • Fax: 617-730-0621
Mailing address:
  • Phone: 912-353-7744
  • Fax: 617-730-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5005257
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number20111450
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2307499
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN272845
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: