Individual
JENNIFER BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(469) 437-3564
(469) 825-6903
Mailing address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(469) 437-3564
(469) 825-6903
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
138106
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209006631
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295726065
—
IL
05
—
918810607
—
MO
01
—
P00298433
RR MEDICARE
MO
01
—
P01410773
RR MEDICARE
IL
Enumeration date
11/02/2005
Last updated
07/23/2025
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