Provider Demographics
NPI:1861798928
Name:BAUER, THERESA ANN (CNM, CNP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:BAUER
Suffix:
Gender:F
Credentials:CNM, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10498 MONTGOMERY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4462
Mailing Address - Country:US
Mailing Address - Phone:513-865-1631
Mailing Address - Fax:513-865-1632
Practice Address - Street 1:10498 MONTGOMERY RD
Practice Address - Street 2:SUITE D
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4462
Practice Address - Country:US
Practice Address - Phone:513-865-1631
Practice Address - Fax:513-865-1632
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04902CNM367A00000X
OH04503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife