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General NPI Number Information
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NPI Number | 1851226278
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Entity Type | Organization
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Legal Business Name | KEIRA BAKER SKN WELLNESS
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 37689 LEAFSIDE LN
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-3804
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Country | US
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Telephone | 813-606-8110
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N # 28048
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-606-8110
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | KEIRA QUEINISE RANDALL
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Credential | NP
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Telephone | 813-606-8110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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