Provider Demographics
NPI:1730995051
Name:BAUR, KATHRYN ANN (LPN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:BAUR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10049 KITSAP MALL BLVD NW STE 201
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8901
Mailing Address - Country:US
Mailing Address - Phone:360-373-6966
Mailing Address - Fax:
Practice Address - Street 1:10049 KITSAP MALL BLVD NW STE 201
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8901
Practice Address - Country:US
Practice Address - Phone:360-373-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60263087164W00000X, 364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse