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General NPI Number Information
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NPI Number | 1811262470
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Entity Type | Individual
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Provider Name | KELLY ERIN BAKER APRN
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Gender | Female
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 2703 RUNNING HORSE RD.
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City | PLATTE CITY
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State | MO
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Zip | 64079-7077
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Country | US
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Telephone | 816-858-7050
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Fax | 816-858-7055
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Provider Business Mailing Address
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Address Line | 2703 RUNNING HORSE RD.
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City | PLATTE CITY
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State | MO
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Zip | 64079-7077
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Country | US
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Telephone | 816-858-7050
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Fax | 816-858-7055
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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 | 2012002568
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License Number State | MO
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