Healthcare Provider Details

I. General information

NPI: 1881833820
Provider Name (Legal Business Name): LINDA M. BAKER ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W. 10TH ST.
INDIANAPOLIS IN
46202
US

IV. Provider business mailing address

1481 W. 10TH ST.
INDIANAPOLIS IN
46202
US

V. Phone/Fax

Practice location:
  • Phone: 317-988-3630
  • Fax: 317-988-3159
Mailing address:
  • Phone: 317-988-3630
  • Fax: 317-988-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number281723074A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2008007629
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number17551
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: