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General NPI Number Information
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NPI Number | 1952185563
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Entity Type | Individual
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Provider Name | RANDI JO BAKER APNP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1976 LIME KILN RD
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City | GREEN BAY
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State | WI
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Zip | 54311-4417
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Country | US
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Telephone | 920-445-7377
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Fax | 920-592-9479
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Provider Business Mailing Address
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Address Line | PO BOX 22487
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City | GREEN BAY
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State | WI
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Zip | 54305-2487
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Country | US
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Telephone | 920-445-7210
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Fax | 920-445-7289
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704313544
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14170-33
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License Number State | WI
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