Individual
HEATHER JACOBSON-BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R27292
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452849
—
ND
Enumeration date
01/22/2007
Last updated
06/14/2016
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