Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | CP002120 | SD |
NPI | 1720756679 |
---|---|
Provider Name | Elizabeth May Bauer |
First Address | Sioux Falls, SD 57105-1513 |
Second Address | Sioux Falls, SD 57105-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2021 |
Last Update Date | 03/09/2021 |