Healthcare Provider Details

I. General information

NPI: 1366868192
Provider Name (Legal Business Name): OLIVIA J BAKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4464 S DIXIE HWY
MIDDLETOWN OH
45005-5464
US

IV. Provider business mailing address

4464 S DIXIE HWY
MIDDLETOWN OH
45005-5464
US

V. Phone/Fax

Practice location:
  • Phone: 513-649-8008
  • Fax: 513-649-8004
Mailing address:
  • Phone: 513-649-8008
  • Fax: 513-649-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN-396299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: