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NPI Code Detail

MEDICARE: KERRIE HOGIN BAKER FNP

MEDICARE: KERRIE HOGIN BAKER FNP
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
1363LF0000XFamily Nurse PractitionerAP131958TX

General Provider Information

NPI Number : 1326431024
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRIE HOGIN BAKER FNP
Provider Business Mailing Address
First Line : 2413 MEMORIAL PKWY
Second Line :
City : PORTLAND
State : TX
Zip : 78374-3209
Country : US
Telephone Number : 361-643-4546
Fax Number :
Provider Business Practice Location Address
First Line : 2413 MEMORIAL PKWY
Second Line :
City : PORTLAND
State : TX
Zip : 78374-3209
Country : US
Telephone Number : 361-643-4546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2015
Last Update Date : 10/27/2022

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