=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134047079
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY ANN BAKER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2026
-----------------------------------------------------
Last Update Date | 07/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10721 CHAPMAN HWY
-----------------------------------------------------
City | SEYMOUR
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37865-4765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-609-1036
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1436 BAKER RD
-----------------------------------------------------
City | SEVIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37876-2567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-712-2920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | 49963
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------