Individual
MARY ANN BAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC, RN
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2605
(928) 214-2892
Mailing address
1200 N. BEAVER STREET, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001
(928) 213-9235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-86798
AZ
176B00000X
Midwife
LM069
AZ
Other
Enumeration date
05/15/2007
Last updated
03/17/2018
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