MEDICARE: MS. DINEZ D 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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1407034754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DINEZ D BAKER

Provider Business Mailing Address
First Line	:	1671 WELLONS DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-5054
Country	:	US
Telephone Number	:	919-396-1222
Fax Number	:	910-339-0237

Provider Business Practice Location Address
First Line	:	1671 WELLONS DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-5054
Country	:	US
Telephone Number	:	919-396-1222
Fax Number	:	910-339-0237

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

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	12/10/2019

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