Healthcare Provider Details

I. General information

NPI: 1114143153
Provider Name (Legal Business Name): ALMARIA BAKER M.ED-IECE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 SIMPSON DRIVE
LOUISVILLE KY
40218
US

IV. Provider business mailing address

3643 NICHOLS MEADOW CIRCLE
LOUISVILLE KY
40215
US

V. Phone/Fax

Practice location:
  • Phone: 502-459-6344
  • Fax:
Mailing address:
  • Phone: 502-363-1580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: