Healthcare Provider Details

I. General information

NPI: 1740194265
Provider Name (Legal Business Name): VANESSA BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MERCY DR NW
CANTON OH
44708-2614
US

IV. Provider business mailing address

2655 WAINWRIGHT RD SE APT A
NEW PHILADELPHIA OH
44663-6874
US

V. Phone/Fax

Practice location:
  • Phone: 330-489-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberAPRN.CNP.0043504
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: