MEDICARE: MS. BRENDA LEA BAKER 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	363LF0000X	Family Nurse Practitioner	229843	AZ

General Provider Information

NPI Number	:	1376997130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRENDA LEA BAKER NP-C

Provider Business Mailing Address
First Line	:	PO BOX 8087
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-0118
Country	:	US
Telephone Number	:	888-706-1444
Fax Number	:	800-306-9538

Provider Business Practice Location Address
First Line	:	17316 N KIMBERLY WAY
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-9686
Country	:	US
Telephone Number	:	575-491-5367
Fax Number	:

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

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	01/28/2026

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