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General NPI Number Information
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NPI Number | 1073153003
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Entity Type | Individual
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Provider Name | DANIELLE BENTRUP BAKER CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 609 W MAPLE AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-751-5711
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Fax | 479-751-1099
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Provider Business Mailing Address
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Address Line | 14700 MEADOWLAND CIR
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City | NEWARK
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State | TX
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Zip | 76071-8905
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Country | US
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Telephone | 318-564-7888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 918052
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 230551
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1001195
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11020306
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 221343
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License Number State | AR
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