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General NPI Number Information
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NPI Number | 1821885278
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Entity Type | Individual
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Provider Name | BREANNE CATHLEEN BAKER
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Gender | Female
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 650 N FULTON ST
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City | FRESNO
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State | CA
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Zip | 93728
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Country | US
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Telephone | 559-488-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 W STUART AVE
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City | FRESNO
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State | CA
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Zip | 93711-2041
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Country | US
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Telephone | 559-824-0875
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | RN95178200
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License Number State | CA
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