=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669581807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET PAMELA BAKER MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 08/29/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 GLENN POND ROAD SUITE 3
-----------------------------------------------------
City | RED HOOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12571-1824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-758-6046
-----------------------------------------------------
Fax | 845-758-6051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 GLENN POND ROAD SUITE 3
-----------------------------------------------------
City | RED HOOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12571-1824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-758-6046
-----------------------------------------------------
Fax | 845-758-6051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F-331519-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------