Jean Marie Baum, PA-C

Individual provider Active NPI Physician Assistant · Lincoln, NE

NPI 1962555201 · NPPES record last updated Apr 22, 2015

Key facts

NPI
1962555201
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
695 (NE)
Practice address
1520 South 70TH St
Ste 200
Lincoln, NE 68506-1566
Phone
(402) 464-9000
Fax
(402) 464-4447
NPI assigned
Jan 19, 2007
Sex
Female
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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001774IAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 695 NE Yes

Addresses

Primary practice location

1520 South 70TH St
Ste 200
Lincoln, NE 68506-1566

Mailing address

1520 South 70TH St
Ste 200
Lincoln, NE 68506-1566
Phone (402) 464-9000

Other providers in Lincoln, NE

All providers in Lincoln, NE · Physician Assistant in Nebraska

Sources for this page

Verify at the official NPI Registry.