=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619636792
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH MAE BAKER LM, CPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2021
-----------------------------------------------------
Last Update Date | 12/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15701 SW 47TH AVENUE RD
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34473-3177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-519-3969
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1879 NE 29TH ST
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34479-2921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-789-5559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | 427
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------