MEDICARE: MEGAN RAE BAYER RN BSN IBCLC

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	163W00000X	Registered Nurse	13-93142-032	KS
2	163WL0100X	Lactation Consultant (Registered Nurse)	108-86036	KS

General Provider Information

NPI Number	:	1780822114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN RAE BAYER RN BSN IBCLC

Provider Business Mailing Address
First Line	:	1019 N ARMOUR ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-1329
Country	:	US
Telephone Number	:	316-648-2768
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 N ARMOUR ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-1329
Country	:	US
Telephone Number	:	316-648-2768
Fax Number	:

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

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/22/2009

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