Individual
SUSAN M BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
205 PORTLAND ST, COLUMBIA, MO 65201-6521
(573) 884-6052
(573) 884-1151
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
063861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425295409
—
MO
01
—
455963
HEALTHLINK
MO
Enumeration date
08/05/2006
Last updated
09/30/2010
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