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General NPI Number Information
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NPI Number | 1578101234
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Entity Type | Individual
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Provider Name | TODD BAER FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 1301 W PARKS HWY STE 101
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City | WASILLA
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State | AK
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Zip | 99654-6939
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Country | US
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Telephone | 907-357-7781
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 W PARKS HWY STE 101
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City | WASILLA
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State | AK
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Zip | 99654-6939
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Country | US
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Telephone | 907-357-7781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 154218
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License Number State | AK
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