Individual
SUSAN L BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1240 E 9TH ST, RENO, NV 89512-2964
(775) 323-0478
Mailing address
1240 E 9TH ST, RENO, NV 89512-2964
(775) 323-0478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1385
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861415382
—
NV
Enumeration date
07/25/2006
Last updated
09/08/2021
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