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General NPI Number Information
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NPI Number | 1255055562
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Entity Type | Individual
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Provider Name | ELIZABETH BAKER
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 2205 CAROLINA RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-1464
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Country | US
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Telephone | 757-477-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 2205 CAROLINA RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-1464
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Country | US
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Telephone | 757-477-3636
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | B201304259
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License Number State | VA
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