Healthcare Provider Details

I. General information

NPI: 1679980635
Provider Name (Legal Business Name): SARAH BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 11/27/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 OLD LEBANON DIRT RD
HERMITAGE TN
37076-2386
US

IV. Provider business mailing address

302 OLD LEBANON DIRT RD
HERMITAGE TN
37076-2386
US

V. Phone/Fax

Practice location:
  • Phone: 615-391-4545
  • Fax: 615-391-4546
Mailing address:
  • Phone: 615-391-4545
  • Fax: 615-391-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18871
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: