Individual
KELLY ANN BAUMGARTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
96194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12909276
DRIVERS LICENSE
TX
Enumeration date
05/21/2019
Last updated
05/21/2019
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