Healthcare Provider Details

I. General information

NPI: 1043133317
Provider Name (Legal Business Name): SIERRA SKYE BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 COLLEGE CORNER PIKE
OXFORD OH
45056-1639
US

IV. Provider business mailing address

5720 COLLEGE CORNER PIKE
OXFORD OH
45056-1639
US

V. Phone/Fax

Practice location:
  • Phone: 513-523-8798
  • Fax: 513-523-5710
Mailing address:
  • Phone: 513-523-8798
  • Fax: 513-523-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOP.017969-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: