Healthcare Provider Details

I. General information

NPI: 1447185897
Provider Name (Legal Business Name): KIMBERLY BAUER RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1466 NE 30 AVE
HARPER KS
67058-8437
US

IV. Provider business mailing address

1466 NE 30 AVE
HARPER KS
67058-8437
US

V. Phone/Fax

Practice location:
  • Phone: 316-239-5519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-319995
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: