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General NPI Number Information
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NPI Number | 1497462451
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Entity Type | Individual
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Provider Name | JORDAN NICOLE BAKER APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 3205 N UNIVERSITY DR STE E
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City | NACOGDOCHES
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State | TX
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Zip | 75965-2683
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Country | US
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Telephone | 936-585-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 662 COUNTY ROAD 2091
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City | NACOGDOCHES
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State | TX
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Zip | 75965-6830
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Country | US
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Telephone | 936-615-5119
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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 | 1095960
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License Number State | TX
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