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NPI Code Detail

MEDICARE: STACY R BAKER

MEDICARE:   STACY R BAKER
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
1376K00000XNurse's Aide

General Provider Information

NPI Number : 1295587111
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY R BAKER
Provider Business Mailing Address
First Line : 9311 S HIGHLAND AVE
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-2331
Country : US
Telephone Number : 440-610-2706
Fax Number :
Provider Business Practice Location Address
First Line : 9311 S HIGHLAND AVE
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-2331
Country : US
Telephone Number : 440-610-2706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2024
Last Update Date : 04/03/2024

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Directions to “ STACY R BAKER ” Practice Location

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