Healthcare Provider Details

I. General information

NPI: 1962318857
Provider Name (Legal Business Name): CECILIA BAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 DAKOTA AVE
SOUTH SIOUX CITY NE
68776-2739
US

IV. Provider business mailing address

PO BOX 939
BELLEVUE NE
68005-0939
US

V. Phone/Fax

Practice location:
  • Phone: 531-242-0387
  • Fax:
Mailing address:
  • Phone:
  • Fax: 402-933-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: