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General NPI Number Information
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NPI Number | 1770091266
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Entity Type | Individual
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Provider Name | JESSIE L BAKER AGACNP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR DEPARTMENT OF CARDIOVASCULAR MEDICINE
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-2750
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Fax | 319-353-6343
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Provider Business Mailing Address
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Address Line | 552 N OLIPHANT ST
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City | WEST BRANCH
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State | IA
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Zip | 52358-9701
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Country | US
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Telephone | 319-325-3514
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | H111156
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License Number State | IA
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