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General NPI Number Information
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NPI Number | 1184661480
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Entity Type | Individual
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Provider Name | AMANDA DIANE BAKER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 1713 6TH AVENUE SOUTH
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City | BIRMINGHAM
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State | AL
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Zip | 35294-0001
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Country | US
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Telephone | 205-996-6870
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Fax |
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Provider Business Mailing Address
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Address Line | 8555 CARRINGTON LAKE CRST
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City | TRUSSVILLE
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State | AL
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Zip | 35173-3802
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Country | US
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Telephone | 205-655-8900
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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 | 1-022229
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License Number State | AL
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