Individual
SUSAN J BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC, GREAT BEND, KS 67530-3213
(620) 792-5848
Mailing address
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC, GREAT BEND, KS 67530-3213
(620) 792-5848
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
44343
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013253
BLUE CROSS INDIV PROVIDER
KS
05
—
200269380A
—
KS
Enumeration date
04/19/2006
Last updated
12/14/2009
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