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NPI Code Detail

MEDICARE: LANA R BAUER

MEDICARE:   LANA R BAUER
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
1172A00000XDriver

General Provider Information

NPI Number : 1932404472
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANA R BAUER
Provider Business Mailing Address
First Line : 36779 240TH AVE SE
Second Line :
City : MCINTOSH
State : MN
Zip : 56556-9258
Country : US
Telephone Number : 218-280-8384
Fax Number :
Provider Business Practice Location Address
First Line : 36779 240TH AVE SE
Second Line :
City : MCINTOSH
State : MN
Zip : 56556-9258
Country : US
Telephone Number : 218-280-8384
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2011
Last Update Date : 01/13/2011

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Directions to “ LANA R BAUER ” Practice Location

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