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General NPI Number Information
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NPI Number | 1710375191
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Entity Type | Individual
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Provider Name | SARAH RENEE BAKER NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 3130 WISCONSIN AVE SUITE 6
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City | JOPLIN
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State | MO
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Zip | 64804-2873
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Country | US
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Telephone | 417-206-9300
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Fax | 417-206-9306
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Provider Business Mailing Address
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Address Line | PO BOX 2009
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City | JOPLIN
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State | MO
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Zip | 64803-2009
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Country | US
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Telephone | 417-206-9300
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Fax | 417-206-9306
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2005002070
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License Number State | MO
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