Healthcare Provider Details

I. General information

NPI: 1508680539
Provider Name (Legal Business Name): REBECCA K BAUMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELOIT CLINIC 1905 E HUEBBE PARKWAY
BELOIT WI
53511-1842
US

IV. Provider business mailing address

BELOIT HEALTH SYSTEM INC 1969 W HART ROAD
BELOIT WI
53511-2230
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-1460
  • Fax: 608-363-7317
Mailing address:
  • Phone: 608-364-1615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16058-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: