Bauer, Jennifer

Bauer, Jennifer is an individual health care provider with primary practice located at 6800 State Route 162 , Maryville IL 62062-8500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Bauer, Jennifer can be contacted via phone (469) 437-3564.

Contact Information

Primary practice address
6800 State Route 162 Maryville IL 62062-8500
Phone: (469) 437-3564
Fax: (469) 825-6903
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 138106 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209006631 Illinois

Profile Details

NPI number 1295726065
LBN Legal business name Bauer, Jennifer
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Apr 29th, 2024 - about 8 months 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 1295726065 NPPES
Illinois MEDICAID 1295726065
Illinois MEDICAID 918810607
Illinois Other P00298433
Illinois Other P01410773

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