Healthcare Provider Details

I. General information

NPI: 1598833295
Provider Name (Legal Business Name): BARBARA S. BAKER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BOSTON SQ
GEORGETOWN KY
40324-9746
US

IV. Provider business mailing address

107 BROADBILL CT
GEORGETOWN KY
40324-9294
US

V. Phone/Fax

Practice location:
  • Phone: 859-619-5488
  • Fax: 502-570-9269
Mailing address:
  • Phone: 859-619-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004916
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: