Healthcare Provider Details

I. General information

NPI: 1770494429
Provider Name (Legal Business Name): SAVANNAH NICOLE BAKER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 HIGHWAY 7 S
OXFORD MS
38655-5392
US

IV. Provider business mailing address

518 COUNTY ROAD 101
OXFORD MS
38655-8439
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-7521
  • Fax:
Mailing address:
  • Phone: 662-816-3563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number924709
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: