Healthcare Provider Details

I. General information

NPI: 1699848226
Provider Name (Legal Business Name): SUSAN GREENE BAKER ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 SOUTHPOINT PKWY SUITE 200
JACKSONVILLE FL
32216-8709
US

IV. Provider business mailing address

7051 SOUTHPOINT PKWY SUITE 200
JACKSONVILLE FL
32216-8709
US

V. Phone/Fax

Practice location:
  • Phone: 904-493-2229
  • Fax: 904-396-4546
Mailing address:
  • Phone: 904-493-2229
  • Fax: 904-396-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP3248922
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: