Healthcare Provider Details

I. General information

NPI: 1467630061
Provider Name (Legal Business Name): DEBORAH S BAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 S MAIN ST
BLUFFTON IN
46714-3616
US

IV. Provider business mailing address

7230 ENGLE RD SUITE 140
FORT WAYNE IN
46804-2234
US

V. Phone/Fax

Practice location:
  • Phone: 260-824-1071
  • Fax: 260-824-5578
Mailing address:
  • Phone: 260-482-3886
  • Fax: 260-482-1910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002621A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: