Individual
BECKY M BAUTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7900
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(082) 828-7900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1590072
MN
363LA2100X
Acute Care Nurse Practitioner
Primary
1424
MN
364SG0600X
Gerontology Clinical Nurse Specialist
477
MN
Other
Enumeration date
10/09/2014
Last updated
07/28/2023
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