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General NPI Number Information
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NPI Number | 1891354114
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Entity Type | Individual
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Provider Name | MICHAEL JOHN BAKER NP
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Gender | Male
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 4502 LT EUGENE J MAJURE DR
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City | PASCAGOULA
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State | MS
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Zip | 39581-5305
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Country | US
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Telephone | 228-696-9224
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Fax | 228-696-9228
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Provider Business Mailing Address
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Address Line | 9066 FIELD BROOK CIR N
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City | MOBILE
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State | AL
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Zip | 36695-9332
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Country | US
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Telephone | 251-370-3007
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 903366
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License Number State | MS
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