Healthcare Provider Details

I. General information

NPI: 1831841055
Provider Name (Legal Business Name): HANNAH CHRISTINE BAUMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 02/02/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 GRANADA ST
LEAWOOD KS
66211-1453
US

IV. Provider business mailing address

11550 GRANADA ST
LEAWOOD KS
66211-1453
US

V. Phone/Fax

Practice location:
  • Phone: 913-451-7546
  • Fax:
Mailing address:
  • Phone: 816-351-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2022048909
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number60623
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02902
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: