Individual
JENNIFER DIANE BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10800 MIDLOTHIAN TPKE STE 309, NORTH CHESTERFIELD, VA 23235
(804) 549-4040
Mailing address
7201 GLEN FOREST DR STE 100, RICHMOND, VA 23226-3759
(804) 549-4030
(804) 549-4032
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
110002369
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00365127
RAILROAD MEDICARE
VA
Enumeration date
10/13/2006
Last updated
07/08/2025
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