Individual
JODY M BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
727 KIRKWOOD MALL, BISMARCK, ND 58504-5753
(701) 712-4500
(701) 712-4011
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 712-4500
(701) 712-4098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0600
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466407
—
ND
Enumeration date
08/12/2015
Last updated
05/16/2023
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