Healthcare Provider Details

I. General information

NPI: 1578492260
Provider Name (Legal Business Name): AVERIE DAWN BAKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 E STOP 11 RD STE 450
INDIANAPOLIS IN
46237-6342
US

IV. Provider business mailing address

4436 WILLOW WIND CT
GREENWOOD IN
46142-9045
US

V. Phone/Fax

Practice location:
  • Phone: 317-865-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: