Healthcare Provider Details

I. General information

NPI: 1871733436
Provider Name (Legal Business Name): ARIC VINCENT BAUDEK CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIRCLE NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH VA
23708
US

IV. Provider business mailing address

1022 TREE BARK TER
MONUMENT CO
80132-6166
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-3198
  • Fax:
Mailing address:
  • Phone: 757-510-4652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9175426
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001207803
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC-APN.0102841-C-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: