Healthcare Provider Details

I. General information

NPI: 1780275701
Provider Name (Legal Business Name): JESSICA SOPHIA BAUMANN DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 02/02/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 ALLEQUIPPA ST
PITTSBURGH PA
15240
US

IV. Provider business mailing address

123 HEATHER DR
PITTSBURGH PA
15209-1854
US

V. Phone/Fax

Practice location:
  • Phone: 412-360-6000
  • Fax:
Mailing address:
  • Phone: 412-657-8621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP023167
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: