Healthcare Provider Details

I. General information

NPI: 1184542243
Provider Name (Legal Business Name): JACQUELINE BAUMGARTNER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 HIGHWAY 3
STEELE ND
58482-9518
US

IV. Provider business mailing address

3511 HIGHWAY 3
STEELE ND
58482-9518
US

V. Phone/Fax

Practice location:
  • Phone: 701-426-4987
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2291
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: