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NPI Code Detail

MEDICARE: MRS. TAMAHRA M BAINES APNP

MEDICARE: MRS. TAMAHRA M BAINES APNP
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
1363LP0200XPediatric Nurse Practitioner1592WI
2363LP0808XPsychiatric/Mental Health Nurse Practitioner1592WI
3363L00000XNurse Practitioner1592WI

Other Identifiers

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

General Provider Information

NPI Number : 1891749156
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAMAHRA M BAINES APNP
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1102 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1708
Country : US
Telephone Number : 608-282-8270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 12/28/2023

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