Individual
PATRICIA A BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
400 HINCKLEY BLVD, SUITE 100, JACKSON, MI 49203-6125
(517) 784-0588
(517) 784-3866
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-0002
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704098056
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3221533
—
MI
01
—
5008764530
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/17/2006
Last updated
11/23/2007
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