Provider Demographics
NPI:1679737266
Name:BAUMGARDNER ASSISTING PLLC
Entity type:Organization
Organization Name:BAUMGARDNER ASSISTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BAUMGARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:502-299-6851
Mailing Address - Street 1:590 BOULDER DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-5113
Mailing Address - Country:US
Mailing Address - Phone:502-299-6851
Mailing Address - Fax:270-234-9932
Practice Address - Street 1:590 BOULDER DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-5113
Practice Address - Country:US
Practice Address - Phone:502-299-6851
Practice Address - Fax:270-234-9932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty