Individual
JENNIFER S BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
621 MEMORIAL DR STE 302, SOUTH BEND, IN 46601-1073
(574) 367-3800
(574) 367-3801
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001701A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014674
—
IN
Enumeration date
10/28/2005
Last updated
03/30/2021
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