Basic Information
| Provider Information | |||||||||
| NPI: | 1649658642 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAUDE | ||||||||
| FirstName: | STACY | ||||||||
| MiddleName: | |||||||||
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| Credential: | RNBC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044016433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079470366 | ||||||||
| FaxNumber: | 2079424350 | ||||||||
| Practice Location | |||||||||
| Address1: | 42 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044016433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079470366 | ||||||||
| FaxNumber: | 2079424350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2015 | ||||||||
| LastUpdateDate: | 05/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | R039342 | ME | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.