Bauer, Jacquelyn P
Bauer, Jacquelyn P is an individual health care provider with primary practice located at 1027 Memorial Dr , Oakland MD 21550-4343. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Bauer, Jacquelyn P can be contacted via phone (301) 533-3300.Contact Information
Primary practice address
1027 Memorial Dr
Oakland MD 21550-4343
Phone: (301) 533-3300
Fax: (833) 448-0361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Neonatal | 363LN0000X | R110105 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R110105 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | SP018623 | Pennsylvania |
Profile Details
| NPI number | 1124010004 |
|---|---|
| LBN Legal business name | Bauer, Jacquelyn P |
| Credentials | C.R.N.P. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Dec 17th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124010004 | NPPES |
| West Virginia | MEDICAID | 0167161000 | |
| West Virginia | MEDICAID | 1124010004 | |
| West Virginia | MEDICAID | 103470021 | |
| West Virginia | MEDICAID | 126751500 |
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