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NPI Code Detail

MEDICARE: JULILLA ROSE BAER

MEDICARE: JULILLA ROSE BAER
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
1390200000XStudent in an Organized Health Care Education/Training Program2000460595IN

General Provider Information

NPI Number : 1336075928
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULILLA ROSE BAER
Provider Business Mailing Address
First Line : 52156 HICKORY RD
Second Line :
City : GRANGER
State : IN
Zip : 46530-7430
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 340 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3082
Country : US
Telephone Number : 317-274-8157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ JULILLA ROSE BAER ” Practice Location

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