Basic Information
| Provider Information | |||||||||
| NPI: | 1003015140 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAUER | ||||||||
| FirstName: | JENNY | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5435 FELTL RD | ||||||||
| Address2: | EMERGENCY PHYSICIANS, P.A. | ||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553437983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528359880 | ||||||||
| FaxNumber: | 9528571554 | ||||||||
| Practice Location | |||||||||
| Address1: | 5435 FELTL RD | ||||||||
| Address2: | EMERGENCY PHYSICIANS, P.A. | ||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553437983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528359880 | ||||||||
| FaxNumber: | 9528571554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 10/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SF0001X | R147286-0 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Family Health |
ID Information
| ID | Type | State | Issuer | Description | 1003015140 | 01 | MN | NPI | OTHER |