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NPI Code Detail

MEDICARE: ANITA LYNN BAKER-ROSS APN, CNM

MEDICARE: ANITA LYNN BAKER-ROSS APN, CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeAPN11590TN
2367A00000XAdvanced Practice Midwife3012814KY

General Provider Information

NPI Number : 1265435671
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA LYNN BAKER-ROSS APN, CNM
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 103
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9446
Country : US
Telephone Number :
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 1312 BISHOP ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-5406
Country : US
Telephone Number : 731-885-5150
Fax Number : 731-885-7584
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 08/27/2020

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