Individual
MRS. TAMAHRA M BAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1102 S PARK ST, MADISON, WI 53715-1708
(608) 282-8270
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1592
WI
363LP0200X
Pediatric Nurse Practitioner
Primary
1592
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1592
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39945600
—
WI
Enumeration date
05/20/2006
Last updated
12/28/2023
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