Healthcare Provider Details

I. General information

NPI: 1790979490
Provider Name (Legal Business Name): COURTNEY KAYE BAKER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 N 21ST ST STE 306
CAMP HILL PA
17011-3707
US

IV. Provider business mailing address

205 GRANDVIEW AVE STE 200D
CAMP HILL PA
17011-1745
US

V. Phone/Fax

Practice location:
  • Phone: 717-516-5539
  • Fax: 724-205-6571
Mailing address:
  • Phone: 724-431-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberOS015327
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: