Healthcare Provider Details

I. General information

NPI: 1033909395
Provider Name (Legal Business Name): DAPHNE BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 2ND ST NW LOT 86
MINOT ND
58703-5207
US

IV. Provider business mailing address

13001 2ND ST NW LOT 86
MINOT ND
58703-5207
US

V. Phone/Fax

Practice location:
  • Phone: 360-631-4755
  • Fax:
Mailing address:
  • Phone: 360-631-4755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: