MEDICARE: DR. KRISTINE BAULA M.D.

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
1	2084P0800X	Psychiatry Physician	53988	KS

General Provider Information

NPI Number	:	1679007082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINE BAULA M.D.

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSING
Second Line	:	3RD FL
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-8668
Country	:	US
Telephone Number	:	502-861-5278
Fax Number	:

Provider Business Practice Location Address
First Line	:	789 EASTERN BYP STE 23
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2421
Country	:	US
Telephone Number	:	859-544-8171
Fax Number	:	859-544-8197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	03/03/2023

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