Healthcare Provider Details

I. General information

NPI: 1750354593
Provider Name (Legal Business Name): JODY WILLIAMS BAKER RN, MSN, APN, C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 10/08/2023
Certification Date: 10/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 COUNTY HOUSE RD
SEWELL NJ
08080-2525
US

IV. Provider business mailing address

508 SHETLAND COURT BUILDING A. SIDE ENTRANCE
SEWELL NJ
08080-2512
US

V. Phone/Fax

Practice location:
  • Phone: 877-823-5230
  • Fax: 215-823-5265
Mailing address:
  • Phone: 609-706-8302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00065900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: