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Individual
JACQUELYN P BAUER
Active
Individual
JACQUELYN P BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
R110105
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
R110105
MD
363LP0200X
Pediatric Nurse Practitioner
SP018623
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0167161000
—
WV
05
—
103470021
—
PA
05
—
1124010004
—
WV
05
—
126751500
—
MD
Enumeration date
08/17/2005
Last updated
12/17/2025
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