Timothy Lewis Baum, CRNP

Individual provider Active NPI Gerontology Nurse Practitioner · Lancaster, PA

NPI 1508874199 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508874199
Entity type
Individual (NPI type 1)
Primary specialty
Gerontology Nurse Practitioner 363LG0600X
License
SP005243H (PA)
Practice address
1861 Charter LN Ste 118
Lancaster, PA 17601-5859
Phone
(717) 290-6900
Fax
(717) 290-1104
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP005243H PA Yes

Addresses

Primary practice location

1861 Charter LN Ste 118
Lancaster, PA 17601-5859

Mailing address

111 E Marion St
Lititz, PA 17543-2015
Phone (717) 290-6900

Other providers in Lancaster, PA

All providers in Lancaster, PA · Gerontology Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.