Healthcare Provider Details

I. General information

NPI: 1851555791
Provider Name (Legal Business Name): SHARON DELORES BAKER BSN MN CWHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON DELORES BAKER BSN MN CWHNP

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DOWNING ST SE
ROME GA
30161-8023
US

IV. Provider business mailing address

2 DOWNING ST
ROME GA
30161-8022
US

V. Phone/Fax

Practice location:
  • Phone: 706-234-8483
  • Fax:
Mailing address:
  • Phone: 706-234-8483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberR2033
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: