Bauer, Jacquelyn P

Bauer, Jacquelyn P is an individual health care provider with primary practice located at 500 Greene St , Cumberland MD 21502-2755. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Bauer, Jacquelyn P can be contacted via phone (301) 724-7616.

Contact Information

Primary practice address
500 Greene St Cumberland MD 21502-2755
Phone: (301) 724-7616
Fax: (301) 724-4811
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X R110105 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X SP018623 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R110105 Maryland

Profile Details

NPI number 1124010004
LBN Legal business name Bauer, Jacquelyn P
Credentials C.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Aug 3rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124010004 NPPES
Pennsylvania MEDICAID 103470021
Pennsylvania MEDICAID 126751500
Pennsylvania MEDICAID 0167161000

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