Individual
KIM MILLER- BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
16820 BALCH PLACE, MANNSVILLE, NY 13661
(315) 523-0681
(315) 523-0681
Mailing address
16820 BALCH PL, MANNSVILLE, NY 13661-4283
(315) 523-0681
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402155-1
NY
Other
Enumeration date
08/25/2017
Last updated
05/27/2020
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