Provider Demographics
NPI:1538453394
Name:BAUDO, MARYANNE (NP-C, MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:
Last Name:BAUDO
Suffix:
Gender:F
Credentials:NP-C, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:211 DELMAR AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3604
Mailing Address - Country:US
Mailing Address - Phone:201-447-6527
Mailing Address - Fax:201-447-7065
Practice Address - Street 1:20-19 FAIR LAWN AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2329
Practice Address - Country:US
Practice Address - Phone:201-797-2003
Practice Address - Fax:201-797-7003
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00277300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health