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NPI Code Detail

MEDICARE: SARA L BAUER NP

MEDICARE: SARA L BAUER NP
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
1363L00000XNurse Practitioner71001512AIN
2363LA2200XAdult Health Nurse Practitioner71001512AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215084124
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA L BAUER NP
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6507 E STATE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-7026
Country : US
Telephone Number : 260-486-3300
Fax Number : 260-486-3600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 04/11/2025

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Directions to “ SARA L BAUER NP” Practice Location

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