Healthcare Provider Details

I. General information

NPI: 1568831048
Provider Name (Legal Business Name): DAWN BAKER AGACNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 SW 6TH AVE
TOPEKA KS
66606-2084
US

IV. Provider business mailing address

1500 SW 10TH AVE MEDICAL STAFF SERVICES
TOPEKA KS
66604
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-4630
  • Fax: 785-270-4628
Mailing address:
  • Phone: 785-354-6241
  • Fax: 785-270-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number78832
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2015025671
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA004522
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: