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NPI Code Detail

MEDICARE: MELISSA BAUMGARDNER CRNA

MEDICARE:   MELISSA  BAUMGARDNER  CRNA
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
1367500000XCertified Registered Nurse Anesthetist521468TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
285909UOTHERTXBCBSTX

General Provider Information

NPI Number : 1467476424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA BAUMGARDNER CRNA
Provider Business Mailing Address
First Line : 464 COUNTY ROAD 1125
Second Line :
City : MAUD
State : TX
Zip : 75567-2610
Country : US
Telephone Number : 903-585-3065
Fax Number :
Provider Business Practice Location Address
First Line : 2001 N JEFFERSON AVE
Second Line :
City : MT PLEASANT
State : TX
Zip : 75455-2371
Country : US
Telephone Number : 903-577-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 09/27/2023

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Directions to “ MELISSA BAUMGARDNER CRNA” Practice Location

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