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NPI Code Detail

MEDICARE: MRS. SUSAN BETH BAUER CRNA

MEDICARE: MRS. SUSAN BETH BAUER 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 AnesthetistWI

General Provider Information

NPI Number : 1902840051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN BETH BAUER CRNA
Provider Business Mailing Address
First Line : 11496 N PORKYS RD
Second Line :
City : HAYWARD
State : WI
Zip : 54843-6362
Country : US
Telephone Number : 715-634-6895
Fax Number :
Provider Business Practice Location Address
First Line : 11040 N STATE ROAD 77
Second Line :
City : HAYWARD
State : WI
Zip : 54843-6391
Country : US
Telephone Number : 715-934-4321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. SUSAN BETH BAUER CRNA” Practice Location

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