Provider Demographics
NPI:1073289344
Name:BAUMBERGER, CARA MARIE (RN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:MARIE
Last Name:BAUMBERGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:MARIE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:534 GOLDEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53536-1449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3102 MERITER WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-5833
Practice Address - Country:US
Practice Address - Phone:608-417-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI242587-30163W00000X
WI16063-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI16063-33OtherADVANCED PRACTICE NURSE PRESCRIBER