Healthcare Provider Details

I. General information

NPI: 1346159654
Provider Name (Legal Business Name): DEE ANN BAUNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10062 LADY OF THE HLS
EVANSVILLE MN
56326-4519
US

IV. Provider business mailing address

10062 LADY OF THE HLS
EVANSVILLE MN
56326-4519
US

V. Phone/Fax

Practice location:
  • Phone: 320-762-8662
  • Fax:
Mailing address:
  • Phone: 320-762-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1132148
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: