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NPI Code Detail

MEDICARE: BONNIE COX BAKER CRNA

MEDICARE: BONNIE COX BAKER CRNA
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
1163W00000XRegistered Nurse225079NC
2367500000XCertified Registered Nurse Anesthetist225079NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912249640
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE COX BAKER CRNA
Provider Business Mailing Address
First Line : 3100 SPRING FOREST RD STE 130
Second Line :
City : RALEIGH
State : NC
Zip : 27616-2880
Country : US
Telephone Number : 919-873-9533
Fax Number : 844-454-0171
Provider Business Practice Location Address
First Line : 3714 GUARDIAN AVE STE W
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-2975
Country : US
Telephone Number : 252-247-0314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2013
Last Update Date : 03/17/2018

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Directions to “ BONNIE COX BAKER CRNA” Practice Location

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