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1558905653
LACI BAUER
MERIDIAN, ID
NPI
1558905653
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID 62999)
Enumeration Date
2019-10-31
Last Update Date
2019-12-05
Business Address
LACI BAUER NP-C
520 S EAGLE RD
MERIDIAN, ID 83642-6351
Phone number: 208-333-2225
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Mailing Address
LACI BAUER NP-C
520 S EAGLE RD STE 1243
MERIDIAN, ID 83642-6355
Phone number: 208-333-2225
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