MEDICARE: LAURA BAKER NP

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
1	363LF0000X	Family Nurse Practitioner	333407	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	404278	NY

General Provider Information

NPI Number	:	1508886292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA BAKER NP

Provider Business Mailing Address
First Line	:	59 CAPE HENRY TRL
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-9677
Country	:	US
Telephone Number	:	585-415-1759
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 LUCIUS GORDON DR STE 2
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-9662
Country	:	US
Telephone Number	:	585-471-3407
Fax Number	:	866-557-9530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/09/2023

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