Healthcare Provider Details

I. General information

NPI: 1033816327
Provider Name (Legal Business Name): JESSICA MARIE BAIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

1404 DEERWOOD TRL
WISCONSIN DELLS WI
53965-9049
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax: 608-280-7265
Mailing address:
  • Phone: 406-459-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number38492
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: