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NPI Code Detail

MEDICARE: MS. KRISTIN KARA NELSON BAUMERT PA-C

MEDICARE: MS. KRISTIN KARA NELSON BAUMERT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMED-PAC-LIC-51706MT
2364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist51706MT

General Provider Information

NPI Number : 1154770014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTIN KARA NELSON BAUMERT PA-C
Provider Business Mailing Address
First Line : 5 W MENDENHALL ST STE 202
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-3566
Country : US
Telephone Number : 406-219-7233
Fax Number :
Provider Business Practice Location Address
First Line : 5 W MENDENHALL ST STE 202
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-3566
Country : US
Telephone Number : 406-219-7233
Fax Number : 866-284-8967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2016
Last Update Date : 05/10/2024

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