Healthcare Provider Details

I. General information

NPI: 1245937010
Provider Name (Legal Business Name): MRS. MALINDA ANN BAUDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. MINDY A BAUDER

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 125TH AVE
ALLEGAN MI
49010-9378
US

IV. Provider business mailing address

3507 125TH AVE
ALLEGAN MI
49010-9378
US

V. Phone/Fax

Practice location:
  • Phone: 616-403-8095
  • Fax:
Mailing address:
  • Phone: 616-403-8095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number7601000176
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: