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Individual

LISA ANN BAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CDDN

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
94145611
CA
163W00000X
Registered Nurse
Primary
R146370-1
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2015015
CERTIFICATION DEVELOPMENTAL DISABILITY NURSE - NATIONAL ASSOCIATION
MN
01
94145611
NURSING LICENSE
CA
01
R146370-1
NURSING LICENSE
MN
Enumeration date
08/01/2018
Last updated
08/01/2018
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