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General NPI Number Information
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NPI Number | 1154643138
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Entity Type | Individual
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Provider Name | PATRICIA J BAKER H.A.S
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Gender | Female
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 1555 ATLANTIC BLVD
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-1717
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Country | US
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Telephone | 904-241-0327
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Fax | 904-241-0311
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Provider Business Mailing Address
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Address Line | 20 CORONA CT
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City | PALM COAST
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State | FL
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Zip | 32137-9021
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Country | US
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Telephone | 386-597-2134
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Fax | 386-579-2190
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AT 4622
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License Number State | FL
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