Individual
SUSAN F BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN NP
Contact information
Practice address
1230 E MAIN ST, MANKATO CLINIC AT MAIN STREET, MANKATO, MN 56001-5066
(507) 625-1811
(507) 625-1878
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811
(507) 625-1878
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0743451
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03A64BA
BCBS
MN
01
—
0401492
MEDICA
MN
01
—
124709
UCARE
MN
01
—
41084933956001C158
CHAMPUS
—
01
—
500004161
RR MEDICARE
—
05
—
599214100
—
MN
05
—
938480
—
IA
01
—
HP40993
HEALTH PARTNERS
MN
01
—
NA2951023871
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
09/22/2011
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