Healthcare Provider Details

I. General information

NPI: 1346144490
Provider Name (Legal Business Name): JENNIFER BAUER BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 HOFFMAN DRAW
KILA MT
59920-9508
US

IV. Provider business mailing address

640 HOFFMAN DRAW
KILA MT
59920-9508
US

V. Phone/Fax

Practice location:
  • Phone: 407-752-9622
  • Fax: 407-752-9622
Mailing address:
  • Phone: 406-885-8078
  • Fax: 407-752-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: