Healthcare Provider Details

I. General information

NPI: 1760605034
Provider Name (Legal Business Name): MARK STEVEN BAKER LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3521 GRAYSTONE PL
CONOVER NC
28613-8201
US

IV. Provider business mailing address

5612 CREEK POINT DR
HICKORY NC
28601-7090
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2050
  • Fax: 828-324-4271
Mailing address:
  • Phone: 828-322-2050
  • Fax: 828-324-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number156FX1100X
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number018088
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: