Laci Bauer, NP-C
Nurse Practitioner in Meridian, ID. Individual provider (NPI-1).
NPI number1558905653
StatusActive
Last updated in NPPESDec 5, 2019
Details
- NPI
- 1558905653
- Entity type
- Individual (NPI-1)
- Name
- Laci Bauer
- Credential
- NP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 31, 2019
- Last updated
- Dec 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 62999 | ID | Yes |
Practice location
520 S Eagle RdMeridian, ID 83642-6351
Phone 208-333-2225 · Fax 208-706-7516
Mailing address
520 S Eagle Rd Ste 1243Meridian, ID 83642-6355
Phone 208-333-2225
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