MEDICARE: DR. RICHARD K BAKER DNP, NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	209013625	IL
2	363LF0000X	Family Nurse Practitioner	143182	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00360425	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285621847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD K BAKER DNP, NP-C

Provider Business Mailing Address
First Line	:	1326 CLARKSON CLAYTON CTR
Second Line	:
City	:	ELLISVILLE
State	:	MO
Zip	:	63011-2145
Country	:	US
Telephone Number	:	314-293-4410
Fax Number	:	314-293-4412

Provider Business Practice Location Address
First Line	:	1326 CLARKSON CLAYTON CTR
Second Line	:
City	:	ELLISVILLE
State	:	MO
Zip	:	63011-2145
Country	:	US
Telephone Number	:	314-293-4410
Fax Number	:	314-293-4412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	01/17/2023

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