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General NPI Number Information
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NPI Number | 1174165807
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Entity Type | Individual
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Provider Name | BROOKE ANN BAKER FNP
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Gender | Female
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 8 CHURCH STREET
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City | EDWARDS
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State | NY
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Zip | 13635
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Country | US
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Telephone | 315-562-1055
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Fax |
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Provider Business Mailing Address
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Address Line | 50 LEROY ST
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City | POTSDAM
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State | NY
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Zip | 13676-1786
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Country | US
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Telephone | 315-265-3300
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 345169
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License Number State | NY
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