MEDICARE: TINA L BAUM APRN, ACNS-BC, CWON

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	364SA2200X	Adult Health Clinical Nurse Specialist	APRN9344546	FL

General Provider Information

NPI Number	:	1851393664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA L BAUM APRN, ACNS-BC, CWON

Provider Business Mailing Address
First Line	:	1395 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3790
Country	:	US
Telephone Number	:	727-943-4111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1395 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3790
Country	:	US
Telephone Number	:	727-942-5000
Fax Number	:

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/30/2019

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